DR. WYATT LEE NICHOLS (NPI# 1265464630) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265464630 |
| Entity Type | Individual |
| Full Name | DR. WYATT LEE NICHOLS |
| Credential | PH.D. |
| Practice Address |
8142 Country Village Dr Ste 102 Cordova TN 38016-2029 |
| Practice Telephone | 9013881893 |
| Practice Fax Number | 9013881995 |
| Mailing Telephone | 9013881893 |
| Mailing Fax Number | 9013881995 |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2018-08-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
P866 | TN | Behavioral Health & Social Service Providers |
| N | 103TF0200X |
Psychologist Specialization: Forensic |
P866 | TN | Behavioral Health & Social Service Providers |
| Street Address |
8142 COUNTRY VILLAGE DR STE 102 |
| City | CORDOVA |
| State | TN |
| Zip Code | 38016-2029 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356715445 | Wyatt L. Nichols, Ph.d., PC | Psychologist | 8142 Country Village Dr Ste 102, Cordova, TN 38016-2029 | 2015-11-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548886872 | Megan Scott Bolton | Physical Therapist | 8110 Cordova Road Suite 107, Cordova, TN 38016 | 2020-06-23 |
| 1477195451 | Jacqueline Reeves Thomas | Counselor | Memphis Veterans Affairs Medical Center (vamc), 1030 Jefferson Ave, Memphis, TN 38016 | 2019-10-11 |
| 1376195842 | Robert Cody Heismann | Physical Therapist | 8110 Cordova Rd, Ste 107, Cordova, TN 38016 | 2019-07-15 |
| 1881189702 | Carolyn Bean | Home Health Aide | 1786 Beaver Trail Dr, Cordova, TN 38016 | 2018-06-22 |
| 1255776886 | Suzanne Elaine Baker | Family Medicine | 2257 North Germantown Parkway, Memphis, TN 38016 | 2013-05-09 |
| 1487806683 | Janet Lee Ferrell | Counselor | 1340 Siskin Drive, Cordova, TN 38016 | 2008-10-21 |
| 1114186624 | Rebecca L Bills | Optometrist | 1795 N Germantown Pkwy, Cordova, TN 38016 | 2008-06-09 |
| 1679784128 | Linda Kay Yates | Emergency Medicine | 1401 Dexter Lane, Cordova, TN 38016 | 2007-05-25 |
| 1417168386 | Healthquest | Psychiatry & Neurology | 58 Timber Creek, Cordova, TN 38016 | 2007-05-24 |
| 1114079795 | Barbara T Henking | Psychologist | 8134 Country Village, #102, Cordova, TN 38016 | 2007-01-17 |
| Find all providers in zip 38016 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447873906 | Virtual Adhd Services and Testing | Psychologist | 8935 Magnolia Leaf Cv, Cordova, TN 38018-7413 | 2020-05-19 |
| 1720635030 | Amy Rebekah Murrell | Psychologist | 8558 Ericson Cv, Cordova, TN 38018-7312 | 2019-08-21 |
| 1508280207 | Poonam Tavkar-conley | Psychologist | 1147 Cully Rd Ste 102, Cordova, TN 38018-8502 | 2014-02-15 |
| 1447698568 | Dr. Mary Wanat Pllc | Psychologist | 8820 Trinity Rd Ste 200, Cordova, TN 38018-2735 | 2013-06-11 |
| 1780759217 | Beth Lyons | Psychologist | 65 Germantown Ct Ste 417, Cordova, TN 38018-4259 | 2006-11-21 |
| 1255432258 | John Robert Hutson | Psychologist | 1540 Appleing Care Lane, 100, Cordova, TN 38016 | 2006-09-25 |
| 1184634362 | Geraldine Bishop Phd PC Inc | Psychologist | 1540 Appling Care Lane, Suite 100, Cordova, TN 38016 | 2006-08-09 |
| 1659306264 | Addie Guinn | Psychologist | 9215 Durhamshire Dr, Cordova, TN 38016-2361 | 2006-07-11 |
| 1023064201 | Sheila L Cohen | Psychologist | 150 Timber Creek Dr, Suite 6, Cordova, TN 38018-4236 | 2006-05-26 |
| 1497743306 | Cynthia Ziegler Mealer | Psychologist | 245 Germantown Bend Cv, Cordova, TN 38018-7238 | 2005-10-13 |
| Find all providers in CORDOVA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.