KENDALL JAMES NICHOLS (MD) – Sleep Medicine (Psychiatry & Neurology) Physician, NPI 1407376650

KENDALL JAMES NICHOLS (MD) is a healthcare provider. based in Minneapolis, Minnesota. specializing in NEUROLOGY. They hold the professional credentials MD. They hold a License No. 97548 (GA). The NPI Number for KENDALL JAMES NICHOLS (MD) is 1407376650

Main info

Male
Sole Proprietor
4 Years Of Experience
Accepts Medicare Assignment
Name
KENDALL JAMES NICHOLS (MD)
NPI
1407376650
Phone
Not provided
Address
420 DELAWARE STREET SE
Enumeration Date
20 June 2017
Last Update Date
6 March 2024

Doctor Profile

Medical School Name
UNIVERSITY OF MINNESOTA MEDICAL SCHOOL
Secondary Phone
4047787525
Graduation Year
2022 (4 years ago)
PAC ID
6901170315
Group Practice PAC ID
8820901408
Professional Enrollment ID
I20240124003706
Address ID
GA303221013AT1365XNEXX400
Telehealth
Yes
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience45
Completeness75
Years active:8State licenses:1Digital endpointsOther names

640 NEUROLOGY in MN

Provider Addresses for KENDALL JAMES NICHOLS (MD)

  • 420 DELAWARE STREET SE

    MMC 295, DEPARTMENT OF NEUROLOGY

    MINNEAPOLIS, MN 55455

    Phone:

    Type: Mailing

  • 12 EXECUTIVE PARK DR NE FL 4

    ATLANTA, GA 303292206

    Phone: (404) 712-7533

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2024-01-24

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
I20240124003706INeurologyGATBD

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 55455)

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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: 8820901408View full group profile
NameSpecialtyState
Interventional Cardiology, Cardiovascular Disease (Cardiology), Internal MedicineCA
Internal MedicineGA
Physician AssistantFL
Interventional Radiology, Diagnostic RadiologyKY
Anesthesiology AssistantGA
-CA
D E R M A T O L O G YGA
Interventional Radiology, Diagnostic RadiologyNC
Physician AssistantGA
-GA

Reviews

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Frequently asked questions

What is the standard ID for KENDALL JAMES NICHOLS (MD) in the U.S.?
In the U.S., KENDALL JAMES NICHOLS (MD) is identified by NPI 1407376650.
Quick check: is KENDALL JAMES NICHOLS (MD) active?
Public NPPES data shows KENDALL JAMES NICHOLS (MD) with an active NPI status right now.
What type of care does KENDALL JAMES NICHOLS (MD) provide?
KENDALL JAMES NICHOLS (MD)'s profile centers on Sleep Medicine (Psychiatry & Neurology) Physician. Clinical services aligned with this taxonomy classification.
Which community is linked to KENDALL JAMES NICHOLS (MD)?
KENDALL JAMES NICHOLS (MD) shows a connection to Minneapolis, Minnesota in registry-derived data.
Why is information missing for KENDALL JAMES NICHOLS (MD)?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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