Active NPI
Luis Miguel Nicacio, D.C., C.C.S.P.
- Rehabilitation Chiropractor
- Richland, WA
National Provider Identifier
1750439063
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rehabilitation Chiropractor
- License
- 2916
- Practice address
- 2568 Queensgate Dr.
Richland, WA 99352 - Phone
- (509) 628-3745
- Fax
- (866) 224-8375
- NPI assigned
- Jan 5, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rehabilitation Chiropractor | 111NR0400X | 2916 | WA | Primary |
| Sports Physician Chiropractor | 111NS0005X | 2916 | WA |
Addresses
Primary practice location
2568 Queensgate Dr.
Richland, WA 99352
Mailing address
2568 Queensgate Drive
Richland, WA 99352
Phone (509) 628-3745
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2916 | WA | MD | Sports Physician Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Family Chiropractic Wellness Center LLC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Chiropractor
- Richland, WA
- NPI 1427221308
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167955200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1280188800000",
"number": "1750439063",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2568 QUEENSGATE DRIVE",
"city": "RICHLAND",
"state": "WA",
"postal_code": "99352",
"telephone_number": "509-628-3745",
"fax_number": "888-224-8375"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2568 QUEENSGATE DR.",
"city": "RICHLAND",
"state": "WA",
"postal_code": "99352",
"telephone_number": "509-628-3745",
"fax_number": "866-224-8375"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NICACIO",
"first_name": "LUIS",
"middle_name": "MIGUEL",
"name_prefix": "Dr.",
"credential": "D.C., C.C.S.P.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-05",
"last_updated": "2010-07-27",
"status": "A"
},
"taxonomies": [
{
"code": "111NR0400X",
"taxonomy_group": "",
"desc": "Chiropractor, Rehabilitation",
"state": "WA",
"license": "2916",
"primary": true
},
{
"code": "111NS0005X",
"taxonomy_group": "",
"desc": "Chiropractor, Sports Physician",
"state": "WA",
"license": "2916",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Richland, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.