Brian Scott Nicol, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

5001183 Issued in WI

Practice address

214 Larkin St
Tomah, WI 54660-0606

Phone

(608) 372-3298

Fax

(608) 372-3128

NPI assigned

Aug 21, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• B Scott Nicol Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Oct 1, 2013 through Oct 1, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: bnicol637025@direct.gundersenhealth.org

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.

• County of Monroe

  • Skilled Nursing Facility
  • Sparta, WI
  • NPI 1952306748
  NPD (past)
• Tomah Family Dentistry LLC

  • General Practice Dentistry
  • Tomah, WI
  • NPI 1558476184
  NPD (past)

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638748800000",
    "number": "1194830711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 606",
            "address_2": "214 LARKIN ST",
            "city": "TOMAH",
            "state": "WI",
            "postal_code": "546600606",
            "telephone_number": "608-372-3298",
            "fax_number": "608-372-3128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "214 LARKIN ST",
            "city": "TOMAH",
            "state": "WI",
            "postal_code": "546600606",
            "telephone_number": "608-372-3298",
            "fax_number": "608-372-3128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICOL",
        "first_name": "BRIAN",
        "middle_name": "SCOTT",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-21",
        "last_updated": "2021-12-06",
        "certification_date": "2021-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "5001183",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33563100",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "B",
            "last_name": "NICOL",
            "middle_name": "SCOTT",
            "credential": "DDS",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Mark Stephen Mueller, DDS
• Daniel Mulrain, RN
• Brooke Murdock, LCSW
• Ayman Magdy Nemr, M.D.
• Megan Nicksic
• Eliel Nieves Torres
• Northland Hearing Centers, Inc.
• Renee Ann Nosbisch, RN
• Gina Lynn Noth, RN
• Wanda M Novak, PA-C

• General Practice Dentistry in Tomah, WI
• Providers in Tomah, WI by specialty
• General Practice Dentistry in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2021; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.