DR. BRENT M NICKISCHER (NPI# 1255368361) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255368361 |
| Entity Type | Individual |
| Full Name | DR. BRENT M NICKISCHER |
| Credential | D.O. |
| Practice Address |
443 English Rd Bath PA 18014 |
| Mailing Address |
443 English Rd Bath PA 18014-9210 |
| Practice Telephone | 6103905596 |
| Mailing Telephone | 6103905596 |
| Enumeration Date | 2006-06-26 |
| Last Update Date | 2018-07-16 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | OS008986L | PA | Allopathic & Osteopathic Physicians |
| Y | 207R00000X | Internal Medicine | OS008986L | PA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | CAQH# | 11585351 | 01 |
| PA | BLUE SHIELD | 0311501 | 01 |
| Street Address |
443 ENGLISH RD |
| City | BATH |
| State | PA |
| Zip Code | 18014 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023536653 | Nicholas Mirabito | Specialist/Technologist | 270 E Northampton St, Bath, PA 18014 | 2017-09-04 |
| 1245783570 | Keystone Med LLC | Pharmacy | 7273-75 Park Drive, Bath, PA 18014 | 2016-08-03 |
| 1578721114 | Luther Edward Beil | General Practice | 2667 Community Drive, Bath, PA 18014 | 2008-05-30 |
| 1841415437 | James M. Orsi | Anesthesiology | 2225 Yost Rd., Bath, PA 18014 | 2007-04-17 |
| 1003999897 | Ronald J Lewullis | Pharmacist | 310 South Walnut St, Bath Drug, Bath, PA 18014 | 2006-10-23 |
| 1194810606 | Estelle R. Stein | Dentist | 116 S. Walnut St., Bath, PA 18014 | 2006-10-03 |
| 1750325064 | Donna Marie Copertino | Chiropractor | 151 N Chestnut St, Bath, PA 18014 | 2006-06-16 |
| 1457305849 | Northampton Chiropractic Center Inc | Chiropractor | 5964 Nor Bath Blvd, Bath, PA 18014 | 2006-05-20 |
| 1164595724 | Glenn A Clearie | Chiropractor | 5964 Nor Bath Blvd, Bath, PA 18014 | 2006-11-15 |
| 1154862175 | H2 Rehabilitation Extension Services | Clinic/Center | 313 S Walnut St, Suite 1, Bath, PA 18014-1024 | 2017-03-09 |
| Find all providers in zip 18014 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699958249 | Myron K Krueger Md Pa | Internal Medicine | 765 High Street, Bath, ME 04530 | 2007-12-06 |
| 1457498990 | Linda K. Blose | Internal Medicine | 2445 Plaza Ct, Bath, PA 18014-8762 | 2007-02-01 |
| 1720002215 | James Howard Raker | Internal Medicine | 51 Winship St, Bath, ME 04530-2843 | 2006-07-27 |
| 1598799934 | Daniel H Wood | Internal Medicine | 1356a Washington St, Bath, ME 04530-2847 | 2006-07-10 |
| 1427082908 | Anselmo Deasis | Internal Medicine | 7433 State Route 54, Bath, NY 14981 | 2006-07-10 |
| 1447284708 | Benjamin S Herman | Internal Medicine | 1356a Washington Street, Bath, ME 04530 | 2006-07-10 |
| 1699776369 | Iftikhar Ahmad | Internal Medicine | 6649 Chrisphalt Dr, Suite 101, Bath, PA 18014-8500 | 2005-08-03 |
| 1568469401 | Amy K Etzweiler | Internal Medicine | 108 Centre St, Bath, ME 04530-2550 | 2005-07-07 |
| 1376546077 | Carol L Holobinko | Internal Medicine | 7603 Route 54, Bath, NY 14810-7930 | 2005-05-27 |
| 1043622012 | Lisa Jennifer Yeh | Internal Medicine | 108 Centre St, Bath, ME 04530-2550 | 2014-05-27 |
| Find all providers in BATH | ||||
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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.