Bryan Stuart Nicol, LAT, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

A160585276 Issued in WA

Practice address

1808 SW 9TH Ave Ste 101
Battle Ground, WA 98604-3284

Phone

(360) 723-0797

NPI assigned

Mar 6, 2018

Last updated

Mar 6, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Proactive Orthopedic and Sports Physical Therapy of Battle Ground

  • Physical Therapy Clinic/Center
  • Battle Ground, WA
  • NPI 1922235738
  NPD (past)
• New Proactive LLC

  dba ProActive Physical Therapy

  • Physical Therapy Clinic/Center
  • Oregon City, OR
  • NPI 1396273199
  NPD (past)

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

{
    "created_epoch": "1520294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1520294400000",
    "number": "1558863449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1226 VISTA OAKS DR",
            "city": "FOREST GROVE",
            "state": "OR",
            "postal_code": "971163091",
            "telephone_number": "503-536-3841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1808 SW 9TH AVE STE 101",
            "city": "BATTLE GROUND",
            "state": "WA",
            "postal_code": "986043284",
            "telephone_number": "360-723-0797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICOL",
        "first_name": "BRYAN",
        "middle_name": "STUART",
        "name_prefix": "Mr.",
        "credential": "LAT, ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-06",
        "last_updated": "2018-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "WA",
            "license": "A160585276",
            "primary": true
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "OR",
            "license": "AT-10174301",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Navin Shiva Nagaraj, MD
• Tiffany Alicia Natland
• Natural Family Midwives LLP
• Nicole Newton, ARNP FNP-C
• Linh Nguyen
• Robert Stewart Nicol, MD
• Tammie Lynn Noelle Ertman, MA, LMHC
• Randall C. Norris, D.C.
• Steve Joseph Noveshen, P.T
• Nu-Life Sportsmedicine and Health Care Center PLLC

• Athletic Trainer in Battle Ground, WA
• Providers in Battle Ground, WA by specialty
• Athletic Trainer in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2018; 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.