Brett Kimberly Nickisch, MA, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

2011027685 Issued in MO

Practice address

724 NE 79TH Ter
Kansas City, MO 64118-1564

Phone

(816) 797-5415

NPI assigned

Jan 6, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1420502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1420502400000",
    "number": "1467840090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "724 NE 79TH TER",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641181564",
            "telephone_number": "816-797-5415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "724 NE 79TH TER",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641181564",
            "telephone_number": "816-797-5415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICKISCH",
        "first_name": "BRETT",
        "middle_name": "KIMBERLY",
        "name_prefix": "Ms.",
        "credential": "MA, CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-01-06",
        "last_updated": "2015-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MO",
            "license": "2011027685",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dorinda M Nicholson, LCSW
• Stephanie M Nicholson, MPT
• Angela Marie Nickell, PT, MSPT
• Barry L. Nickell, M.D.
• Margaret B Nickell, M.D.
• Pamela Nicklaus, M.D.
• Sarah Nickman, PHARMD
• Sage Nicolaus, NP
• Nicole'S Advocate, LLC
• Rebecca Sue Nidiffer, RT KS 16-02775

• Speech-Language Pathologist in Kansas City, MO
• Providers in Kansas City, MO by specialty
• Speech-Language Pathologist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2015; 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.