Individual provider Active NPI

Bryan Scott Nicholas, DC

  • Chiropractor
  • Clearwater, FL
National Provider Identifier
1205385317
Registry record updated Mar 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
11961 Issued in FL
Practice address
26750 US Highway 19 N Ste 100
Clearwater, FL 33761-3404
Phone
(277) 726-1460
Fax
(727) 724-9705
NPI assigned
Sep 30, 2016
Last updated
Mar 14, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 11961 FL Primary

Addresses

Primary practice location

26750 US Highway 19 N Ste 100
Clearwater, FL 33761-3404

Mailing address

26750 US Highway 19 N Ste 100
Clearwater, FL 33761-3404
Phone (277) 726-1460

Other practice location 1

1001 37th St N Ste D
St Petersburg, FL 33713-6010
Phone (727) 914-9130

Other practice location 2

667 W Lumsden Rd
Brandon, FL 33511-5911
Phone (813) 867-7323

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210326000955 FL Practitioner - Chiropractic 9830506427 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
National University of Arts and Sciences, Medical Department, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Total Vitality Medical Group, LLCGroup PAC ID 6103887195, 6 clinicians

Practice addresses (Care Compare)

26750 US Hwy 19 N
Suite 100
Clearwater, FL 33761-3404
Phone (727) 726-1460

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11961FLMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Total Vitality Medical Group, LLC Chiropractor CurrentSince Mar 14, 2022 Accepting new patients
Suncoast Total Healthcare LLC CurrentSince Mar 14, 2022 Accepting new patients

Locations

667 W Lumsden Rd
Brandon, FL 33511
Phone (813) 867-7323

24945 US Highway 19 N
Clearwater, FL 33763
Phone (727) 726-1460

26750 US Highway 19 N
Ste 100
Clearwater, FL 33761
Phone (727) 726-1460

1001 37th St N
Ste D
St Petersburg, FL 33713
Phone (727) 327-6897

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1475193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741910400000",
    "number": "1205385317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26750 US HIGHWAY 19 N STE 100",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337613404",
            "telephone_number": "277-726-1460",
            "fax_number": "727-724-9705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26750 US HIGHWAY 19 N STE 100",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337613404",
            "telephone_number": "277-726-1460",
            "fax_number": "727-724-9705"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1001 37th St N Ste D",
            "address_purpose": "LOCATION",
            "city": "St Petersburg",
            "state": "FL",
            "postal_code": "337136010",
            "country_code": "US",
            "telephone_number": "727-914-9130",
            "fax_number": "727-914-9131",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "667 W Lumsden Rd",
            "address_purpose": "LOCATION",
            "city": "Brandon",
            "state": "FL",
            "postal_code": "335115911",
            "country_code": "US",
            "telephone_number": "813-867-7323",
            "fax_number": "813-867-7326",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NICHOLAS",
        "first_name": "BRYAN",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-09-30",
        "last_updated": "2025-03-14",
        "certification_date": "2025-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "11961",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clearwater, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.