MR. MICHAEL SCOTT NICKERSON (NPI# 1649691122) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649691122 |
| Entity Type | Individual |
| Full Name | MR. MICHAEL SCOTT NICKERSON |
| Credential | MS, ARNP-C, COHN-S |
| Practice Address |
700 5th Ave S St. Petersburg FL 33785 |
| Mailing Address |
2625 Ne 14th Ave Apt 105 Oakland Park FL 33334-4395 |
| Practice Telephone | 7277678404 |
| Mailing Telephone | 2397779788 |
| Enumeration Date | 2013-12-30 |
| Last Update Date | 2015-01-07 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
3297762 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932672441 | Michael W Nickerson | Behavioral Analyst | 415 Davenport Ave, Valparaiso, FL 32580-1074 | 2019-01-07 |
| 1790927671 | Michael David Nickerson Jr. | Anesthesiology | 3551 Roger Brooke Drive, San Antonio Medical Center Department of Anesthesia, Jbsa Fort Sam Houston, TX 78234 | 2009-03-24 |
| 1699954198 | Michael Jefferey Nickerson | Counselor | 433 Salinas St, Salinas, CA 93901-2717 | 2007-10-31 |
| 1801926357 | Michael David Nickerson Sr. | Dentist | 240 South Main Street, Kilmarnock, VA 22482 | 2007-03-06 |
| 1942219381 | Michael Nickerson | Nurse Practitioner | 333 Borthwick Ave, Emergency Department, Portsmouth, NH 03801-7128 | 2006-08-05 |
| Street Address |
700 5TH AVE S |
| City | ST. PETERSBURG |
| State | FL |
| Zip Code | 33785 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003833732 | Florence Josephine Frain | Psychologist | 19239 Gulf Blvd, Unit #1, Indian Shores, FL 33785 | 2006-07-17 |
| 1033696349 | Radiance Medical Solutions, Inc. | Durable Medical Equipment & Medical Supplies | 19455 Gulf Blvd Ste 3a, Indian Shores, FL 33785-2000 | 2018-07-20 |
| 1588179097 | Emerald Medical Supply, Inc | Durable Medical Equipment & Medical Supplies | 19455 Gulf Blvd Ste 5, Indian Shores, FL 33785-2000 | 2017-12-06 |
| 1487169991 | Ks Medical Solutions, Inc | Durable Medical Equipment & Medical Supplies | 19455 Gulf Blvd Ste 8, Indian Shores, FL 33785-2000 | 2017-12-06 |
| 1992828719 | Walter Flora IIi | Optometrist | 19217 Gulf Blvd, Indian Shores, FL 33785-2111 | 2007-04-08 |
| 1023424215 | On Sight Eyecare, Inc | Optometrist | 19217 Gulf Blvd, Indian Shores, FL 33785-2111 | 2014-07-08 |
| 1417367988 | Robert Klem | Pharmacist | 19450 Gulf Blvd Apt 401, Indian Shores, FL 33785-2260 | 2014-05-05 |
| 1881082188 | Total Rehab Services | Home Health | 19728 Gulf Blvd # 3, Indian Shores, FL 33785-2308 | 2015-01-08 |
| 1457869059 | Indian Shores Bracing, Inc. | Durable Medical Equipment & Medical Supplies | 19823 Gulf Blvd Ste A, Indian Shores, FL 33785-2368 | 2018-01-17 |
| 1144775404 | United Health Group | Point of Service | 19811 Gulf Blvd, 401, Indian Shores, FL 33785-2387 | 2016-08-16 |
| Find all providers in zip 33785 | ||||
| Taxonomy Code | 363LA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Adult Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235432261 | Ashley Gortemoller Briggs | Nurse Practitioner | 600 8th Street South, Suite A, St. Petersburg, FL 33701 | 2010-12-14 |
| 1699779439 | Therese M. Hulme | Nurse Practitioner | 1839 Central Avenue, St. Petersburg, FL 33713 | 2005-06-09 |
| 1245254119 | Susan Aileen Lewis | Nurse Practitioner | 10000 Bay Pines Blvd, St. Petersburg, FL 33708 | 2006-07-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871193292 | Paulette Vital-herne | Nurse Practitioner | 4449 Old Highway 41 S, Sun City, FL 33586-9700 | 2020-10-26 |
| 1144828104 | Shilpa Narahari Reddy | Nurse Practitioner | 19435 N Coquina Way, Weston, FL 33332-2417 | 2020-10-13 |
| 1023615440 | Bridget Mary Rossi | Nurse Practitioner | 1536 Alford Street, Unit 5, Jacksonville, FL 32207-3220 | 2020-10-08 |
| 1154928612 | Haili Harless | Nurse Practitioner | 3961 23rd Ave N, Saint Petersburg, FL 33713-4850 | 2020-10-07 |
| 1679170674 | Lorena Beatriz Canelon | Nurse Practitioner | 16151 Sw 147th Ln, Miami, FL 33196-6416 | 2020-10-04 |
| 1851998082 | Sanon Edmond | Nurse Practitioner | 5236 Arbor Glen Cir, Lake Worth, FL 33463-8066 | 2020-10-01 |
| 1710594114 | Sumelia Waddell | Nurse Practitioner | 462 Ne 210th Circle Ter Apt 204, Miami, FL 33179-5236 | 2020-09-29 |
| 1780291526 | Ilmary De Los Angeles Jimenez | Nurse Practitioner | 7909 Biltmore Blvd, Miramar, FL 33023-5829 | 2020-09-25 |
| 1972119535 | Dennis Carmelo Cadiz Serfino | Nurse Practitioner | 1960 Willesdon Dr E, Jacksonville, FL 32246-0694 | 2020-09-18 |
| 1760097745 | Amanee Orra | Nurse Practitioner | 3982 Bee Ridge Rd Ste H-a, Sarasota, FL 34233-1211 | 2020-09-15 |
| Find all providers with the same taxonomy | ||||
| City | ST. PETERSBURG |
| Zip Code | 33785 |
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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.