Stephen Michael Nickell Jr., M.A., ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

2012028530 Issued in MO

Practice address

1 University PLZ
Ms 7650
Cape Girardeau, MO 63701-4710

Phone

(573) 986-6841

NPI assigned

Apr 26, 2007

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

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": "1177545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1396569600000",
    "number": "1740400407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2142 KENNETH DR",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637011863",
            "telephone_number": "937-631-4660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 UNIVERSITY PLZ",
            "address_2": "MS 7650",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637014710",
            "telephone_number": "573-986-6841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICKELL",
        "first_name": "STEPHEN",
        "middle_name": "MICHAEL",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "M.A., ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-26",
        "last_updated": "2014-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MO",
            "license": "2012028530",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ronald Brent New, MD
• Sydney Newell, DPT
• Dennis Nguyen, D.D.S.
• Duc T. Nguyen, D.O.
• Huan Luong Nguyen, MD
• Heather Lee Nickelson, MOTR/L
• Kevin Andrew Niedbalski, PHARMD, BCGP
• William Joseph Nienaber, MD
• John Eugene Nimmo
• Nirmal K Samanta

• Athletic Trainer in Cape Girardeau, MO
• Providers in Cape Girardeau, MO by specialty
• Athletic Trainer in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2014; 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.