David Scott Nickerson, MD

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

2688A Issued in WY

Practice address

56 Crown Dr
Big Horn, WY 82833

Phone

(307) 674-9875

Fax

(307) 678-7393

NPI assigned

Oct 14, 2014

Last updated

Oct 14, 2014By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. D. Scott Nickerson Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1413244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413244800000",
    "number": "1871997213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "56 CROWN DRIVE",
            "city": "BIG HORN",
            "state": "WY",
            "postal_code": "828330278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "56 CROWN DR",
            "city": "BIG HORN",
            "state": "WY",
            "postal_code": "82833",
            "telephone_number": "307-674-9875",
            "fax_number": "307-678-7393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICKERSON",
        "first_name": "DAVID",
        "middle_name": "SCOTT",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-10-14",
        "last_updated": "2014-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "WY",
            "license": "2688A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "D. SCOTT",
            "last_name": "NICKERSON",
            "prefix": "DR.",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Craig Hilton Johnson, DDS
• Sara Daniela Mone, LPC
• Daniel M Pettyjohn
• Arthur C Pollack, M.D.
• Virginia M Starr, MPT
• Virginia Karuna Starr

• Orthopaedic Surgery Physician in Big Horn, WY
• Providers in Big Horn, WY by specialty
• Orthopaedic Surgery Physician in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.