Individual provider Active NPI

Nicole Albrecht Dawis, M.D.

  • Psychiatry Physician
  • Salt Lake City, UT
National Provider Identifier
1740627330
Registry record updated Mar 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
4301102971 Issued in MI
Practice address
324 E 10TH Ave Ste 178
Salt Lake City, UT 84103-2885
Phone
(801) 408-8500
Fax
(801) 408-8510
NPI assigned
May 23, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 4301102971 MI Primary

Addresses

Primary practice location

324 E 10TH Ave Ste 178
Salt Lake City, UT 84103-2885

Mailing address

324 E 10TH Ave Ste 178
Salt Lake City, UT 84103-2885
Phone (801) 408-8500

Other names 1

  • Nicole Michelle Albrecht Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170707001436 UT Practitioner - Psychiatry 7911276944 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Michigan State University College of Human Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ihc Health Services IncGroup PAC ID 1850209420, 3,948 clinicians

Practice addresses (Care Compare)

324 E 10TH Ave
Suite 178
Salt Lake City, UT 84103-2885
Phone (801) 408-8500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4301102971MIMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services, Inc. Psychiatry CurrentSince Jul 3, 2017 Accepting new patients
Ihc Health Services Inc Current Accepting new patients
Ihc Health Services Inc CurrentSince Jul 3, 2017 Accepting new patients

Locations

700 S Highway 99
Ste 3
Fillmore, UT 84631
Phone (435) 743-5555

390 N Main St
N Salt Lake, UT 84010
Phone (801) 294-1000

5770 S 250 E
Ste 300
Salt Lake City, UT 84107
Phone (801) 314-2500

324 Tenth Ave
Ste 178
Slc, UT 84103
Phone (801) 321-2500

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1369267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711497600000",
    "number": "1740627330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "324 E 10TH AVE STE 178",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841032885",
            "telephone_number": "801-408-8500",
            "fax_number": "801-408-8510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "324 E 10TH AVE STE 178",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841032885",
            "telephone_number": "801-408-8500",
            "fax_number": "801-408-8510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAWIS",
        "first_name": "NICOLE",
        "middle_name": "ALBRECHT",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-23",
        "last_updated": "2024-03-27",
        "certification_date": "2024-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MI",
            "license": "4301102971",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "ALBRECHT",
            "middle_name": "MICHELLE",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.