Provider Demographics
NPI:1598855959
Name:NICOLAI, THOMAS PATRICK (DC)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:PATRICK
Last Name:NICOLAI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:493 BLACKWELL RD
Mailing Address - Street 2:STE 350
Mailing Address - City:WARRENTON
Mailing Address - State:VA
Mailing Address - Zip Code:20186-2628
Mailing Address - Country:US
Mailing Address - Phone:540-347-5900
Mailing Address - Fax:
Practice Address - Street 1:493 BLACKWELL RD
Practice Address - Street 2:STE 350
Practice Address - City:WARRENTON
Practice Address - State:VA
Practice Address - Zip Code:20186-2628
Practice Address - Country:US
Practice Address - Phone:540-347-5900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-13
Last Update Date:2016-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND656111N00000X
VA0104556763111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND18614OtherBCBS ID
ND11157Medicaid
ND18614OtherBCBS ID
ND350048429Medicare ID - Type UnspecifiedRR MEDICARE
VAVAA101782Medicare PIN
NDN18614Medicare ID - Type UnspecifiedMEDICARE ID