DR. ALPHONSO III NICHOLS (MD) – Psychiatry Physician, NPI 1003890666

DR. ALPHONSO III NICHOLS (MD) is a healthcare provider. based in La grange, Kentucky. specializing in PSYCHIATRY. They hold the professional credentials MD. They hold a License No. C177109 (CA). The NPI Number for DR. ALPHONSO III NICHOLS (MD) is 1003890666

Main info

Male
24 Years Of Experience
Accepts Medicare Assignment
Name
DR. ALPHONSO III NICHOLS (MD)
NPI
1003890666
Phone
(502) 817-0927
Address
PO BOX 45
Enumeration Date
6 December 2005
Last Update Date
10 March 2025

Doctor Profile

Medical School Name
UNIVERSITY OF LOUISVILLE SCHOOL OF MEDICINE
Secondary Phone
8584127362
Graduation Year
2002 (24 years ago)
PAC ID
3779651450
Group Practice PAC ID
7810170446
Professional Enrollment ID
I20220714001011
Address ID
CA921313973SA10672STXX302
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience87
Completeness75
Years active:20State licenses:3Digital endpointsOther names

398 PSYCHIATRY in KY

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Provider Addresses for DR. ALPHONSO III NICHOLS (MD)

  • La Grange, Vif, Grenoble, Isère, Auvergne-Rhône-Alpes, Metropolitan France, 38450, France

    LA GRANGE, KY 400310045

    Phone: (502) 817-0927

    Fax: (502) 805-0690

    Type: Mailing

  • 3121, Brooklawn Campus Drive, Louisville, Jefferson County, Kentucky, 40218, United States

    LOUISVILLE, KY 402181282

    Phone: (502) 817-0927

    Fax: (502) 805-0690

    Type: Location

  • 9750 MIRAMAR RD STE 200

    SAN DIEGO, CA 921264562

    Phone: (858) 412-7362

    Fax: (858) 368-9797

    Type: Location

  • 10755 SCRIPPS POWAY PKWY # 455

    SAN DIEGO, CA 921313924

    Phone: (858) 412-7362

    Fax: (858) 368-9797

    Type: Mailing

  • 10672 WEXFORD ST STE 280

    SAN DIEGO, CA 921313973

    Phone: (858) 412-7362

    Fax: (858) 368-9797

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 2 Open Payments records for all available years, with a total value of $40.

Total Amount is formed as General ($40) + Research ($0) + Ownership ($0) = $40.

Last reported payment date: 2023-03-11 • Largest payer in this snapshot: Ironshore Pharmaceuticals Inc. ($25).

Total Amount

$40

General + Research + Ownership

Payments

2

Total payment records

General Amount

$40

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-03-11

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2022-07-14

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20220714001011IPsychiatryCATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
90833Psychotherapy with evaluation and management visit, 30 minutes21737$0
99214Established patient office or other outpatient visit, 30-39 minutes18429$0
99204New patient office or other outpatient visit, 45-59 minutes2020$0
View full utilization report →

Insurance plans in this area (ZIP 40031)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 7810170446View full group profile
NameSpecialtyState
Allergy/Immunology, Internal MedicineCA
P S Y C H I A T R YCA

Reviews

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Frequently asked questions

Does DR. ALPHONSO III NICHOLS (MD) have a public NPI I can cite?
Public records show DR. ALPHONSO III NICHOLS (MD) under NPI 1003890666.
Is DR. ALPHONSO III NICHOLS (MD) currently accepting referrals based on NPI status?
Registry metadata lists DR. ALPHONSO III NICHOLS (MD) as active.
What does the directory say DR. ALPHONSO III NICHOLS (MD) does?
Insurance directories may phrase it differently, but here DR. ALPHONSO III NICHOLS (MD) maps to Psychiatry Physician. Clinical services aligned with this taxonomy classification.
Which community is linked to DR. ALPHONSO III NICHOLS (MD)?
DR. ALPHONSO III NICHOLS (MD) shows a connection to La Grange, Kentucky in registry-derived data.
Can I export DR. ALPHONSO III NICHOLS (MD)'s record?
You can download the official NPPES record; we summarize key fields for readability.

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