BRIAN J NICKERSON (NPI# 1295761930) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295761930 |
| Entity Type | Individual |
| Full Name | BRIAN J NICKERSON |
| Credential | ATC |
| Practice Address |
100 W Gore St Suite 204 Orlando FL 32806-1044 |
| Mailing Address |
130 Avery Lake Dr Winter Springs FL 32708-5191 |
| Practice Telephone | 4078358818 |
| Practice Fax Number | 4078358878 |
| Mailing Telephone | 4079711883 |
| Mailing Fax Number | 4078358878 |
| Enumeration Date | 2006-06-24 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
AL 96 | FL | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871017921 | Brian E Nickerson | Social Worker | 2925 Russell St, Detroit, MI 48207-4825 | 2017-07-31 |
| Street Address |
100 W GORE ST SUITE 204 |
| City | ORLANDO |
| State | FL |
| Zip Code | 32806-1044 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972592426 | Alden E Sanborn | Family Medicine | 100 W Gore St, Suite 605, Orlando, FL 32806-1044 | 2005-10-18 |
| 1356971394 | Stephanie Marie Cook | Dermatology | 100 W Gore St, Orlando, FL 32806-1044 | 2020-01-17 |
| 1801350426 | Sara Lynne Nartatez | Nurse Practitioner | 100 W Gore St, Orlando, FL 32806-1044 | 2019-01-28 |
| 1487125530 | Victor Edouard Buzon | Nurse Practitioner | 100 W Gore St, Orlando, FL 32806-1044 | 2018-12-16 |
| 1649752544 | Sean Coad | Clinical Neuropsychologist | 100 W Gore St, Orlando, FL 32806-1044 | 2018-09-06 |
| 1912483595 | Ruhonney Howells | Nurse Practitioner | 100 W Gore St, Orlando, FL 32806-1044 | 2018-07-17 |
| 1598207300 | Daniel Alfonso Prieto Romero | Nurse Practitioner | 100 W Gore St, Orlando, FL 32806-1044 | 2016-11-09 |
| 1043689763 | Mindy Ley | Physician Assistant | 100 W Gore St, Orlando, FL 32806-1044 | 2015-09-23 |
| 1588900831 | John P Karabatos, M.d. P.a. | Internal Medicine | 100 W Gore St, Ste 406, Orlando, FL 32806-1044 | 2012-12-13 |
| 1659627560 | Bradley J Daniels | Psychologist | 100 W Gore St, Orlando, FL 32806-1044 | 2012-07-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710585674 | Erika Williams | Pharmacist | 2715 South Orlando Ave, Orlando, FL 32806 | 2020-10-13 |
| 1013545664 | Johanna Yadira Cook | Registered Nurse | Orlando Health Orlando Regional Medical Center, 52 W. Underwood St, Orlando, FL 32806 | 2020-03-30 |
| 1396372306 | Warren Andrew Williams | Student in an Organized Health Care Education/Training Program | 1222 S. Orange Ave., 5th Fl, Mp# 43, Orlando, FL 32806 | 2020-03-27 |
| 1225665433 | Astrid Helen Casin | Student in an Organized Health Care Education/Training Program | 1222 S. Orange Avenue, 5th Fl., Mp#43, Orland, FL 32806 | 2020-03-26 |
| 1508404211 | Hidden Potential Florida LLC | Assistant Behavior Analyst | 2857 South Bumby Avenue, Orlando, FL 32806 | 2019-12-12 |
| 1720639883 | Cynthia Lee Kling | Clinical Nurse Specialist | Arnold Palmer Hospital, 92 W. Miller St., Orlando, FL 32806 | 2019-09-20 |
| 1033769930 | Darleen Ann Williams | Clinical Nurse Specialist | 52 W. Underwood, Orlando, FL 32806 | 2019-09-13 |
| 1508412644 | Trischaday Kimberley Demetrius | Nurse Practitioner | Orlando Epilepsy Center, 226 W Michigan Street, Orlando, FL 32806 | 2019-08-14 |
| 1962964809 | Ajc Software Inc | Prosthetic/Orthotic Supplier | 1405 South Orange Avenue Suite 308, Orlando, FL 32806 | 2019-04-01 |
| 1598232852 | Sodo Smiles Dentistry, Pa | Dentist | 3123 S. Orange Ave., Suite 107, Orlando, FL 32806 | 2018-10-25 |
| Find all providers in zip 32806 | ||||
| Taxonomy Code | 2255A2300X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Specialist/Technologist |
| Specialization | Athletic Trainer |
| Athletic trainers are allied health care professionals who work in consultation with or under the direction of physicians, and specialize in the prevention, assessment, treatment and rehabilitation of injuries and illnesses. Currently, the entry-level employment requirements are a bachelor’s degree with a major in athletic training from an accredited university or college. A majority of athletic trainers hold advanced degrees. National board certification is generally required as a condition of state licensure and employment. Most states regulate athletic trainers, and they practice within the scope of that license or regulation. Clinical practice includes emergency care, rehabilitation, reconditioning, therapeutic exercise, wellness programs, exercise physiology, kinesiology, biomechanics, nutrition, psychology and health care administration. |
| Notes: Source: National Athletic Trainers’ Association (www.NATA.org) [1/1/2006: modified definition, modified source] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770182651 | Sarah Danielle Combs | Specialist/Technologist | 4521 Lenmore Street, Orlando, FL 32812 | 2020-10-21 |
| 1861003501 | Zuzanna Barbara Maciejewska | Specialist/Technologist | 11172 Point Sylvan Cir Apt 29c, Orlando, FL 32825-6046 | 2020-08-16 |
| 1457960312 | Chris Gadah | Specialist/Technologist | 12340 Boggy Creek Rd, Orlando, FL 32824-6902 | 2020-07-27 |
| 1831716141 | Kelley April Gosling | Specialist/Technologist | 3829 Winding Lake Cir, Orlando, FL 32835-2655 | 2020-07-02 |
| 1801425806 | Brittney Marie Webb | Specialist/Technologist | 2475 Abalone Blvd, Orlando, FL 32833-3966 | 2020-04-02 |
| 1538707989 | Alan Bradley Zemel | Specialist/Technologist | 368 Lakeview St, Orlando, FL 32804-6882 | 2019-12-17 |
| 1003461948 | Jason Kirkman | Specialist/Technologist | 10402 Glassborough Dr, Orlando, FL 32825-5924 | 2019-08-07 |
| 1396399846 | Steven Outlaw | Specialist/Technologist | 216 Spencer St, Orlando, FL 32839 | 2019-08-01 |
| 1427600188 | Samuel G Winters | Specialist/Technologist | 5818 Petunia Ln, Orlando, FL 32821-5511 | 2019-07-12 |
| 1922563428 | Lindsay Perrin | Specialist/Technologist | 4058 Teriwood Ave, Orlando, FL 32812-7946 | 2019-02-08 |
| Find all providers in ORLANDO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.