Michael L Nicholas, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

01036176A Issued in IN

Practice address

2506 Willowbrook Pkwy
Suite 300
Indianapolis, IN 46205-1564

Phone

(317) 574-1254

Fax

(317) 674-0059

NPI assigned

Jul 13, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Aspire Indiana Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Carmel, IN
  • NPI 1124016050

  Psychiatry

  NPD
• State of Indiana, Auditor of State

  • Public Health or Welfare Agency
  • Indianapolis, IN
  • NPI 1023613403
  NPD
• State of Indiana, Auditor of State

  • Psychiatric Hospital
  • Indianapolis, IN
  • NPI 1043338684
  NPD
• State of Indiana, Auditor of State

  • Psychiatric Hospital
  • Madison, IN
  • NPI 1700876224
  NPD

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

{
    "created_epoch": "1121212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1306972800000",
    "number": "1124026059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9615 E 148TH ST",
            "address_2": "SUITE 1",
            "city": "NOBLESVILLE",
            "state": "IN",
            "postal_code": "460604360",
            "telephone_number": "317-587-0500",
            "fax_number": "317-674-0059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2506 WILLOWBROOK PKWY",
            "address_2": "SUITE 300",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462051564",
            "telephone_number": "317-574-1254",
            "fax_number": "317-674-0059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLAS",
        "first_name": "MICHAEL",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-13",
        "last_updated": "2011-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IN",
            "license": "01036176A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100353310",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nicholas Catton DDS LLC
• Nicholas F Hrisomalos MD PC
• Bryn Katherine Nicholas, BCABA
• Karen Nicholas
• Keonna Nicholas, RBT
• Natalie A Nicholas, SPEECH LANGUAGE PATH
• Chong H Nicholls, MD
• Nathanael Charles Nicholls
• Alison Nichols
• Amy Susan Nichols, M.S.

• Psychiatry Physician in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Psychiatry Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2011; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.