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KENZIE ANN NICHOLS
NPI 1417642687
Physician Assistant in Pine Bluffs, WY

Active since April 05, 2023PECOS EnrolledAccepts Medicare Assignment
830 SANDERS DR, PINE BLUFFS, WY 82082(307) 575-7835 Get Directions Write a Review

NPPES record last updated: October 17, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Kenzie Ann Nichols NPPES

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

KENZIE ANN NICHOLS (NPI 1417642687) is an individual physician assistant in Pine Bluffs, Wyoming and active in the NPI registry since April 2023. She is enrolled in Medicare PECOS, is affiliated with Cheyenne Regional Medical Center, and is a graduate of Other (2023).

NPPES Registry Identity

NPI1417642687
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameKENZIE ANN NICHOLS
Location Address830 SANDERS DRPine Bluffs, WY 82082-9755
Mailing Address830 Sanders DrPine Bluffs, WY 82082-9755 · (307) 575-7835
Phone(307) 575-7835
Sole ProprietorNo
Medical School CMSOtherGraduated 2023
Enumeration DateApril 5, 2023
Last NPPES UpdateOctober 17, 2025
NPPES CertifiedOctober 17, 2025
✔ NPI 1417642687 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
830 SANDERS DR, Pine Bluffs, WY 82082
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Other Names 1

Former Name (1)Kenzie Ann Graves

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross Blue Shield of Wyoming, Medica.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

Kenzie Ann Nichols 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 ID7719320464
PECOS Enrollment IDI20240209000034
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.

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Emergency department visit with high level of medical decision making 99285
An emergency department visit for severe conditions is when you urgently seek medical help due to serious health issues. These could be severe injuries, breathing problems, unbearable pain, or sudden severe illness. Doctors and nurses will provide immediate care to stabilize your condition.
216 services206 patients
Emergency department visit with moderate level of medical decision making 99284
An emergency department visit for a high-severity issue means you're experiencing a serious health problem that needs immediate attention. This could be a severe injury, serious illness, or life-threatening condition. Medical professionals will provide urgent care to stabilize your condition.
117 services112 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Cheyenne Regional Medical Center

Acute Care Hospitals · Cheyenne, WY
4/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number530014
Location214 East 23rd StreetCheyenne, WY 82001 · Laramie County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 82082 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
$87.12 typical visit price
range $56.42 – $170.72
Typical copayment $21.78 (range $14.10 – $42.68)
Most-billed visit code 99203
Established Patient
$70.32 typical visit price
range $18.19 – $139.32
Typical copayment $17.58 (range $4.54 – $34.83)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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 Kenzie Nichols's NPI number?

The NPI number for Kenzie Nichols is 1417642687. It was assigned to this individual provider in the NPPES registry on April 5, 2023. The provider is also known as Kenzie Ann Graves.

Where is Kenzie Nichols located?

Kenzie Nichols practices at 830 Sanders Dr, Pine Bluffs, WY 82082. The listed phone number is (307) 575-7835.

What is Kenzie Nichols's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Kenzie Nichols enrolled in Medicare?

Yes. Kenzie Nichols 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 Kenzie Nichols accept?

Health plans from Blue Cross Blue Shield of Wyoming and Medica list Kenzie Nichols 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.

Is Kenzie Nichols affiliated with any hospitals?

According to CMS data, Kenzie Nichols is affiliated with Cheyenne Regional Medical Center.

When was this NPI record last updated?

The NPPES record for Kenzie Nichols was last updated on October 17, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 months 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.