Flagstaff Neurosurgery PLLC

Primary specialty

Neurological Surgery PhysicianTaxonomy code 207T00000X

License

30127 Issued in AZ

Legal business name

FLAGSTAFF NEUROSURGERY PLLC

Practice address

823 N San Francisco St
Suite F
Flagstaff, AZ 86001

Phone

(928) 226-7667

Fax

(928) 226-7664

NPI assigned

Jan 4, 2013

Last updated

Jun 28, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Bradley Robert Nicol, MDNPI 1669447488

Title

Owner

Phone

(928) 226-7667

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/19333/brand/1/csg/1/fhir/r4

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Bradley Robert Nicol, MD

  • Neurological Surgery Physician
  • Flagstaff, AZ
  • NPI 1669447488
  Authorized official Same address or phone
• Robert M Evans, PA-C

  • Surgical Physician Assistant
  • Flagstaff, AZ
  • NPI 1881651362
  NPD (past)
• David J. Sacco, M.D.

  • Neurological Surgery Physician
  • Dallas, TX
  • NPI 1386656767
  NPD (past)

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

{
    "created_epoch": "1357257600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687910400000",
    "number": "1073850582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "823 N SAN FRANCISCO ST",
            "address_2": "SUITE F",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "86001",
            "telephone_number": "928-226-7667",
            "fax_number": "928-226-7664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "823 N SAN FRANCISCO ST",
            "address_2": "SUITE F",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "86001",
            "telephone_number": "928-226-7667",
            "fax_number": "928-226-7664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLAGSTAFF NEUROSURGERY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-04",
        "last_updated": "2023-06-28",
        "certification_date": "2023-06-28",
        "status": "A",
        "authorized_official_last_name": "NICOL",
        "authorized_official_first_name": "BRADLEY",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "928-226-7667",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "AZ",
            "license": "30127",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "701690",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Flagstaff Medical Center (Guardian Medical Transport)
• Flagstaff Medical Center (Flagstaff Pharmacy)
• Flagstaff Medical Center (FMC Behavioral Health Services)
• Flagstaff Medical Center
• Flagstaff Modern Dentistry
• Flagstaff OBGYN LLC
• Flagstaff Pain & Treatment Center (Virtuous Pain Centers)
• Flagstaff Pain and Treatment Center
• Flagstaff Pathology Associates (Pathology Associates of Northern AZ)
• Flagstaff Pediatric Dentistry, P.C.

• Neurological Surgery Physician in Flagstaff, AZ
• Providers in Flagstaff, AZ by specialty
• Neurological Surgery Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.