DR. EDWARD PETER NIKICICZ (NPI# 1639267040) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639267040 |
| Entity Type | Individual |
| Full Name | DR. EDWARD PETER NIKICICZ |
| Credential | M.D. |
| Practice Address |
801 S Adams St Srmc, Lab Petersburg VA 23803-5149 |
| Mailing Address |
3908 Mctyres Cove Ct Midlothian VA 23112-4665 |
| Practice Telephone | 8048625028 |
| Mailing Telephone | 8047446140 |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2009-07-02 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207ZP0102X |
Pathology Specialization: Anatomic Pathology & Clinical Pathology |
VA0101047885 | VA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | 6600727 | 05 | |
| VA | BCBS | 086358 | 01 |
| Street Address |
801 S ADAMS ST SRMC, LAB |
| City | PETERSBURG |
| State | VA |
| Zip Code | 23803-5149 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205835725 | Raphael Agada | Internal Medicine | 801 S Adams St, Petersburg, VA 23803-5149 | 2005-07-18 |
| 1932229119 | Dogwood Emergency Physicians | Emergency Medicine | 801 S Adams St, Petersburg, VA 23803-5149 | 2007-03-30 |
| 1447349444 | Manuel Borja Gonzales | Pathology | 801 S Adams St, Laboratory, Petersburg, VA 23803-5149 | 2006-10-11 |
| 1073624888 | Michelle A Cooper | Physician Assistant | 801 S Adams St, Petersburg, VA 23803-5149 | 2006-08-31 |
| 1396856126 | Suel Peter Kim | Emergency Medicine | 801 S Adams St, Petersburg, VA 23803-5149 | 2006-08-31 |
| 1235142795 | Michelle Lorene Bryant-albright | Emergency Medicine | 801 S Adams St, Petersburg, VA 23803-5149 | 2006-08-15 |
| 1477592608 | Virginia Em-i Medical Services, PC | Emergency Medicine | 801 S Adams St, Petersburg, VA 23803-5149 | 2006-06-05 |
| 1447201744 | Virginia Em-i Medical Services, PC | Emergency Medicine | 801 S Adams St, Petersburg, VA 23803-5149 | 2006-05-12 |
| 1760444665 | Stanislaw Z. Wilk | Nurse Anesthetist, Certified Registered | 801 S Adams St, Petersburg, VA 23803-5149 | 2006-04-05 |
| 1689636847 | Sandra Smith | Nurse Anesthetist, Certified Registered | 801 S Adams St, Petersburg, VA 23803-5133 | 2006-04-04 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619523719 | Wise Journey Ltd | Home Health | 325-b Brown Street Suite 132, Petersburg, VA 23803 | 2019-08-14 |
| 1386101699 | Marliqua Barnes | Driver | 601 Carter St, Petersburg, VA 23803 | 2019-02-22 |
| 1356596571 | Quality Healthcare Inc | Community/Behavioral Health | 6111 Duncan Rd, Ste F, Petersburg, VA 23803 | 2008-12-02 |
| 1861614943 | Peoples Family Dental Care | Dentist | 1328 W Washington St, Petersburg, VA 23803 | 2007-05-02 |
| 1841333721 | Family Preservation Services, Inc | Community/Behavioral Health | 1000 Patterson Ave, Petersburg, VA 23803 | 2007-02-14 |
| 1154473155 | Progressive Adult Rehabilitation Center, Inc. | Day Training, Developmentally Disabled Services | 114 North Union Street, Suite B, Petersburg, VA 23803 | 2007-01-18 |
| 1861556615 | Evelyn V. Whitehead | Counselor | 115 E Wythe St, Petersburg, VA 23803 | 2006-12-19 |
| 1538248778 | Raymond Gibson Smith Jr. | Dentist | Seventh Avenue, Hiram Davis Medical Center, Petersburg, VA 23803 | 2006-11-06 |
| 1396842282 | Eugene Arthur Richardson IIi | Dentist | 23 Shore Street, Petersburg, VA 23803 | 2006-09-20 |
| 1679594030 | Olumuyiwa Akinniyi Ojediran | Internal Medicine | 734 South Sycamore Street, Petersburg, VA 23803 | 2006-07-21 |
| Find all providers in zip 23803 | ||||
| Taxonomy Code | 207ZP0102X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pathology |
| Specialization | Anatomic Pathology & Clinical Pathology |
| A pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the laboratory application of the biologic, chemical and physical sciences. A pathologist uses information gathered from the microscopic examination of tissue specimens, cells and body fluids, and from clinical laboratory tests on body fluids and secretions for the diagnosis, exclusion and monitoring of disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added, 7/1/2009: definition reformatted] Additional Resources: American Board of Pathology, 2007. http://www.abpath.org/ This taxonomy code identifies the combined anatomic pathology & clinical pathology route. Board certification for Medical Doctors (MDs) is provided by the American Board of Pathology. To acknowledge the diverse activities in the practice of pathology and to accommodate the interests of individuals wanting to enter the field, the ABP offers primary certification through the following three routes: combined anatomic pathology and clinical pathology, anatomic pathology only and clinical pathology only. Primary certification in anatomic pathology or clinical pathology may be combined with some of the subspecialty certifications. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154493534 | Edward P. Nikicicz, M.d., P.C. | Pathology | 200 Medical Park Blvd, Petersburg, VA 23805-9274 | 2006-11-14 |
| 1871679704 | Petersburg Pathology Associates Ltd. | Pathology | 200 Medical Park Blvd, Petersburg, VA 23805-9274 | 2006-10-31 |
| 1447349444 | Manuel Borja Gonzales | Pathology | 801 S Adams St, Laboratory, Petersburg, VA 23803-5149 | 2006-10-11 |
| 1932170909 | Brad Thomas Siegmund | Pathology | 200 Medical Park Blvd, Petersburg, VA 23805-9274 | 2006-01-30 |
| 1982604120 | John William Summerville | Pathology | 200 Medical Park Blvd, Petersburg, VA 23805 | 2005-07-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952821308 | Patricija Zot | Pathology | 1250 E Marshall St # 980662, Richmond, VA 23298-5051 | 2017-06-26 |
| 1508248949 | Rajeswari Jayakumar | Pathology | 403 N. 13th Street, Csc, Richmond, VA 23298 | 2015-06-22 |
| 1891192209 | Pepper Path LLC | Pathology | 45945 Trefoil Ln, Unit 175, Sterling, VA 20166-4343 | 2014-12-01 |
| 1477953578 | Jonathan Edwards | Pathology | Bon Secours Mary Immaculate Hospital, Pathology Dept, 2 Bernardine Dr, Newport News, VA 23602 | 2014-08-26 |
| 1629481700 | David Phillip Lebel II | Pathology | 1 Riverside Cir Ste 105, Roanoke, VA 24016-4961 | 2014-06-06 |
| 1710304761 | Sara Ali Mustafa | Pathology | 3289 Woodburn Rd Ste 220, Annandale, VA 22003-7313 | 2014-03-27 |
| 1215376959 | Angela Yu-jye Wu | Pathology | 1215 Lee Street - Box Number 800214, Charlottesville, VA 22908-0001 | 2013-06-16 |
| 1043529365 | Alden W Dudley Jr. | Pathology | 5909 Winnbrook Dr, Roanoke, VA 24018-7903 | 2010-10-04 |
| 1649582412 | Vasavi Kaliki | Pathology | 4505 Yorkminster Dr, Glen Allen, VA 23060-6157 | 2010-07-09 |
| 1063737146 | William F. Enos, M.d., Pllc | Pathology | 10300 Spotsylvania Avenue, Suite 130, Fredericksburg, VA 22408 | 2010-04-01 |
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| City | PETERSBURG |
| Zip Code | 23803 |
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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.