1. Home
  2. Directory
  3. South Carolina
  4. Anderson
  5. Nurse Practitioner
  6. NPI Profile

KENNY L NICHOLSON MSN, APRN, PMHNP-BC
NPI 1215626213
Nurse Practitioner - Psychiatric/Mental Health in Anderson, SC

Active since May 04, 2023PECOS EnrolledAccepts Medicare Assignment
125 MUDDY TOES DR, ANDERSON, SC 29626(864) 353-3384(864) 222-9715 Get Directions Write a Review

NPPES record last updated: May 4, 2023. Verified against the NPPES registry weekly; last sync: August 30, 2026.

About Kenny L Nicholson Msn, Aprn, Pmhnp-bc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KENNY L NICHOLSON MSN, APRN, PMHNP-BC (NPI 1215626213) is an individual psychiatric/mental health provider in Anderson, South Carolina, licensed in South Carolina (27318) and active in the NPI registry since May 2023. He is enrolled in Medicare PECOS and is a graduate of Other (2022).

NPPES Registry Identity

NPI1215626213
Entity TypeIndividualMale
Primary Taxonomy363LP0808X
Provider Legal NameKENNY L NICHOLSONCredential: MSN, APRN, PMHNP-BC
Location Address125 MUDDY TOES DRAnderson, SC 29626-5349
Mailing Address113 Shadowood CtSeneca, SC 29678-1275 · (864) 985-3915
Phone(864) 353-3384
Fax(864) 222-9715
Sole ProprietorYes
Medical School CMSOtherGraduated 2022
Enumeration DateMay 4, 2023
NPPES CertifiedApril 24, 2023
✔ NPI 1215626213 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
License✔ Licensed in SC · 27318
125 MUDDY TOES DR, Anderson, SC 29626
Open in Google Maps ↗

Other Names 1

Professional Name (2)Ken L Nicholson Msn, Aprn, Pmhnp-bc

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include UnitedHealthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Kenny L Nicholson Msn, Aprn, Pmhnp-bc is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID4880179126
PECOS Enrollment IDI20260403001225
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 29626 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$83.18 typical visit price
range $53.57 – $163.84
Typical copayment $20.79 (range $13.39 – $40.96)
Most-billed visit code 99203
Established Patient
$95.12 typical visit price
range $16.96 – $133.52
Typical copayment $23.78 (range $4.24 – $33.38)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

WHITNEY SMITH LPC
Counselor
125 MUDDY TOES DR
ANDERSON, SC 29626
Anderson County (864) 353-3384
COUNSELING FOR LIFE, INC.
Counselor (Professional)
125 MUDDY TOES DR
ANDERSON, SC 29626
Anderson County (864) 353-3384
MICHAELE KUBACZ
Counselor (Professional)
125 MUDDY TOES DR
ANDERSON, SC 29626
Anderson County (864) 353-3384
MRS. LISA ANN MANGOLD LPC
Counselor (Mental Health)
125 MUDDY TOES DR
ANDERSON, SC 29626
Anderson County (864) 353-3384
MICHAELA J TOMBERLIN M.A.
Counselor (Professional)
125 MUDDY TOES DR
ANDERSON, SC 29626
Anderson County (864) 353-3384
MRS. MARTHA HINES DUNCAN M.ED, LPC, LPC-S
Counselor (Professional)
125 MUDDY TOES DR
ANDERSON, SC 29626
Anderson County (864) 353-3384
DANA COURTNEY DESPRADEL LISW CP
Social Worker (Clinical)
125 MUDDY TOES DR
ANDERSON, SC 29626
Anderson County (864) 353-3384

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kenny Nicholson's NPI number?

The NPI number for Kenny Nicholson is 1215626213. It was assigned to this individual provider in the NPPES registry on May 4, 2023. The provider is also known as Ken L Nicholson Msn, Aprn, Pmhnp-Bc.

Where is Kenny Nicholson located?

Kenny Nicholson practices at 125 Muddy Toes Dr, Anderson, SC 29626. The listed phone number is (864) 353-3384.

What is Kenny Nicholson's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Is Kenny Nicholson enrolled in Medicare?

Yes. Kenny Nicholson is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Kenny Nicholson accept?

Health plans from UnitedHealthcare list Kenny Nicholson as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Kenny Nicholson was last updated on May 4, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.