ANDREW NICHOLS PH.D.
NPI 1902054091
Psychologist in Park City, UT

Active since September 03, 2008Opted out of Medicare · through Jan 1, 2028
1389 CENTER DR, STE 200, PARK CITY, UT 84098(435) 565-1816 Get Directions Write a Review

NPPES record last updated: November 6, 2014. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Andrew Nichols Ph.d. NPPES

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

ANDREW NICHOLS PH.D. (NPI 1902054091) is an individual psychologist in Park City, Utah, licensed in Utah (8651960-2501) and active in the NPI registry since September 2008. He has opted out of Medicare through January 1, 2028 and remains eligible to order and refer.

NPPES Registry Identity

NPI1902054091
Entity TypeIndividualMale
Primary Taxonomy103T00000X
Provider Legal NameANDREW NICHOLSCredential: PH.D.
Location Address1389 CENTER DR, STE 200Park City, UT 84098-7659
Mailing Address1389 Center Dr, Ste 200Park City, UT 84098-7659 · (435) 565-1816
Sole ProprietorYes
Enumeration DateSeptember 3, 2008
Last NPPES UpdateNovember 6, 2014
NPI 1902054091 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
Licenses Licensed in UT · 8651960-2501 Licensed in NY · 019911
Definition
A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.
1389 CENTER DR, Park City, UT 84098

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

Opted out of Medicare

Andrew Nichols Ph.d. has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from January 1, 2016 through January 1, 2028.

Opt-Out Effective DateJanuary 1, 2016
Opt-Out In Effect ThroughJanuary 1, 2028Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

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 Andrew Nichols's NPI number?

The NPI number for Andrew Nichols is 1902054091. It was assigned to this individual provider in the NPPES registry on September 3, 2008.

Where is Andrew Nichols located?

Andrew Nichols practices at 1389 Center Dr Ste 200, Park City, UT 84098. The listed phone number is (435) 565-1816.

What is Andrew Nichols's specialty?

The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.

Is Andrew Nichols enrolled in Medicare?

No. Andrew Nichols has opted out of Medicare through January 1, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

When was this NPI record last updated?

The NPPES record for Andrew Nichols was last updated on November 6, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.