Active NPI
Robert L Nicholas, M.D.
- Psychiatry Physician
- Atlanta, GA
National Provider Identifier
1114365954
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 021422
- Practice address
- 1790 Century Blvd NE
Suite a
Atlanta, GA 30345-3322 - Phone
- (404) 636-1444
- NPI assigned
- Jun 13, 2013
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 021422 | GA | Primary |
Addresses
Primary practice location
1790 Century Blvd NE
Suite a
Atlanta, GA 30345-3322
Mailing address
1790 Century Blvd NE
Suite a
Atlanta, GA 30345-3322
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 021422 | GA | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1371081600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1371081600000",
"number": "1114365954",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1790 CENTURY BLVD NE",
"address_2": "SUITE A",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303453322"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1790 CENTURY BLVD NE",
"address_2": "SUITE A",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303453322",
"telephone_number": "404-636-1444"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NICHOLAS",
"first_name": "ROBERT",
"middle_name": "L",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-06-13",
"last_updated": "2013-06-13",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "GA",
"license": "021422",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Atlanta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.