Stephen S Nickse, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CH0007165 Issued in FL

Practice address

10863 Park Blvd
Suite 2
Seminole, FL 33772-5423

Phone

(727) 399-2229

Fax

(727) 399-2228

NPI assigned

Aug 30, 2005

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

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Specialty

Chiropractic

Education

Life Chiropractic College, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Seminole Chiropractic Injury & Wellness Center Inc

  • Chiropractor
  • Seminole, FL
  • NPI 1851570220
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1125360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1288569600000",
    "number": "1881687374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10863 PARK BLVD",
            "address_2": "SUITE 2",
            "city": "SEMINOLE",
            "state": "FL",
            "postal_code": "337725423",
            "telephone_number": "727-399-2229",
            "fax_number": "727-399-2228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10863 PARK BLVD",
            "address_2": "SUITE 2",
            "city": "SEMINOLE",
            "state": "FL",
            "postal_code": "337725423",
            "telephone_number": "727-399-2229",
            "fax_number": "727-399-2228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICKSE",
        "first_name": "STEPHEN",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-30",
        "last_updated": "2010-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH #0007165",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH0007165",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS ID#",
            "identifier": "55540",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FL CLINIC LICENSE #",
            "identifier": "HCC 2141",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FL LICENSE #",
            "identifier": "CH #0007165",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "381927200",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "55540",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Patricia Ann Nickol, ITDS
• Nicole Martino DMD, P.a.
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• Chiropractor in Seminole, FL
• Providers in Seminole, FL by specialty
• Chiropractor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.