Baron Tyrone Nickleberry, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

9283 Issued in TX

Practice address

7410 Blanco Rd
San Antonio, TX 78216-4363

Phone

(800) 404-6050

NPI assigned

May 2, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Airrosti Center, Inc.

  • Rehabilitation Chiropractor
  • San Antonio, TX
  • NPI 1902088594
  NPD (past)

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

{
    "created_epoch": "1178064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219363200000",
    "number": "1205058310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7410 BLANCO RD STE 400",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782164363",
            "telephone_number": "800-404-6050",
            "fax_number": "210-477-4956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7410 BLANCO RD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782164363",
            "telephone_number": "800-404-6050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICKLEBERRY",
        "first_name": "BARON",
        "middle_name": "TYRONE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-02",
        "last_updated": "2008-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "9283",
            "primary": true
        },
        {
            "code": "111NR0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Rehabilitation",
            "state": "TX",
            "license": "9283",
            "primary": false
        },
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "TX",
            "license": "9283",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William Dale Nicholson, LCDC
• Nick S Aguilar MD PA (Aguilar Family Health Care)
• Shelly R Nickels, MD
• Abigail Nickelson, IONM
• Corey Phillips Nickerson
• Cecilia Patrice Nickles, HIS
• Claire E. Nickson, OT
• Oleg Nicolaev, DDS
• Nina Corinne Nicolaides, LPC
• Rochele Marie Nicolas-Wedige, FNP

• Chiropractor in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Chiropractor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2008; 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.