Robert Craig Nicks, PHD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

38214 Issued in TX

Practice address

700 S Palestine St
Athens, TX 75751-3342

Phone

(903) 675-9570

Fax

(903) 675-9577

NPI assigned

Apr 20, 2020

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

East Texas Psychological Services, PLLC 9 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• East Texas Psychological Services, PLLC

  • Clinical Psychologist
  • Athens, TX
  • NPI 1093029951

  TX

  Medicare reassignment Care Compare group NPD
• Community Counseling Center Inc

  • Clinical Social Worker
  • Athens, TX
  • NPI 1285946343
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1587340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587340800000",
    "number": "1053931014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2536",
            "city": "ATHENS",
            "state": "TX",
            "postal_code": "757517536",
            "telephone_number": "903-675-9570",
            "fax_number": "903-675-9577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 S PALESTINE ST",
            "city": "ATHENS",
            "state": "TX",
            "postal_code": "757513342",
            "telephone_number": "903-675-9570",
            "fax_number": "903-675-9577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICKS",
        "first_name": "ROBERT",
        "middle_name": "CRAIG",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-04-20",
        "last_updated": "2020-04-20",
        "certification_date": "2020-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "TX",
            "license": "38214",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Athens",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "Athens",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Athens",
            "address_1": "700 S Palestine St",
            "city": "Athens",
            "state": "TX",
            "country_code": "US",
            "postal_code": "757513342",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• All providers in Athens, TX
• Psychologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.