Active NPI
Brenda J. Nicolai, PT, MHS, OCS
- Physical Therapist
- Sikeston, MO
National Provider Identifier
1023450822
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 00438
- Practice address
- 806 S Kingshighway St
Sikeston, MO 63801-5919 - Phone
- (573) 887-3200
- Fax
- (573) 887-2400
- NPI assigned
- Jul 22, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 00438 | MO | Primary |
Addresses
Primary practice location
806 S Kingshighway St
Sikeston, MO 63801-5919
Mailing address
806 S Kingshighway St
Sikeston, MO 63801-5919
Phone (573) 887-3200
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 00438 | MO | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Missouri Delta Medical Center | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Community/Retail Pharmacy
- Malden, MO
- NPI 1578371621
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1374451200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1393545600000",
"number": "1023450822",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "806 S KINGSHIGHWAY ST",
"city": "SIKESTON",
"state": "MO",
"postal_code": "638015919",
"telephone_number": "573-887-3200",
"fax_number": "573-887-2400"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "806 S KINGSHIGHWAY ST",
"city": "SIKESTON",
"state": "MO",
"postal_code": "638015919",
"telephone_number": "573-887-3200",
"fax_number": "573-887-2400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NICOLAI",
"first_name": "BRENDA",
"middle_name": "J.",
"credential": "PT, MHS, OCS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-07-22",
"last_updated": "2014-02-28",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MO",
"license": "00438",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sikeston, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.