Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mr. Tad Nickerson, ATC

Individual provider Athletic Trainer · NPI 1336498369

Mr. Tad Nickerson, ATC is an Athletic Trainer in Virginia Beach, Virginia. Practices as a sole proprietor. Licensed in Virginia.

Licensed in
VA
In the registry since
2012
What do these letters mean?
ATC — Certified Athletic Trainer
Prevents and treats sport and activity injuries.

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Practice location Address checks out

1096 Oakton Mews
Virginia Beach, VA 23464-5355
Phone: (757) 581-8112
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Athletic Trainer (primary) Taxonomy 2255A2300X · Licence 0126000247 (VA)

Record details

NPI number1336498369
Entity typeIndividual (Type 1)
GenderMale
Credentials ATC
Sole proprietorYes
NPI enumeratedSeptember 6, 2012
Last updated in NPPESSeptember 6, 2012

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