Brigham Nicoll

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

55458 Issued in AZ

Practice address

2601 E Roosevelt St
Phoenix, AZ 85008-4973

Phone

(602) 344-5011

NPI assigned

Apr 13, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

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.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/25353/brand/1/csg/1/fhir/r4
• FHIR API: https://api.platform.athenahealth.com/19260/brand/1/csg/1/fhir/r4
• FHIR API: https://fhir4.healow.com/fhir/r4/FBIFDD
• FHIR API: https://fhir4.healow.com/fhir/r4/FBIFDD/Endpoint/FBIFDD

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.

• Aurora Behavioral Healthcare - Tempe, LLC

  • Psychiatric Hospital
  • Tempe, AZ
  • NPI 1164744736

  Psychiatry

  Medicare reassignment NPD
• District Medical Group, Inc

  • Anatomic Pathology & Clinical Pathology Physician
  • Phoenix, AZ
  • NPI 1336472448
  Medicare reassignment NPD
• Grove Comprehensive Psychiatry and Wellness PLLC

  • Psychiatry Physician
  • Mesa, AZ
  • NPI 1144196171
  NPD Authorized official
• The Grove: Comprehensive Psychiatry and Wellness

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Mesa, AZ
  • NPI 1598416364

  Psychiatry

  NPD Authorized official
• District Medical Group, Inc

  • Emergency Medicine Physician
  • Phoenix, AZ
  • NPI 1144624339
  NPD
• District Medical Group, Inc

  • Psychiatry Physician
  • Mesa, AZ
  • NPI 1437482544
  NPD
• District Medical Group, Inc

  • Internal Medicine Physician
  • Phoenix, AZ
  • NPI 1295968162

  Family Medicine

  NPD (past)

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

{
    "created_epoch": "1460505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576713600000",
    "number": "1003260233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2601 E ROOSEVELT ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850084973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2601 E ROOSEVELT ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850084973",
            "telephone_number": "602-344-5011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICOLL",
        "first_name": "BRIGHAM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-13",
        "last_updated": "2019-12-19",
        "certification_date": "2019-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "AZ",
            "license": "55458",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Noelle M Nicolas, SLP
• Kyrie Jae Nicolds, PA-C
• Nicole Lazorwitz PSYD LLC
• Nicolex LLC
• Nicolex LLC Dba Moon Valley Eyecare
• Caleb Glen Nicoll, OTR/L
• Kevin Nicoll, MD
• Angie Nicolucci
• Heidi Marie Nida-Huff, FNP-C
• Nidaa LLC

• Psychiatry Physician in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Psychiatry Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2019; 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.