Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

KEVIN NICKERSON MD
NPI 1871277970
Family Medicine in Girard, PA

Q: What is Kevin Nickerson's NPI number?

The NPI number for Kevin Nickerson is 1871277970. It was assigned to this individual provider in the NPPES registry on June 12, 2023.

Q: What is Kevin Nickerson's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for Kevin Nickerson was last updated on August 31, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since June 12, 2023

5165 IMPERIAL PKWY, GIRARD, PA 16417(814) 774-3128(814) 774-0915 Get Directions Write a Review

NPPES record last updated: August 31, 2026. Verified against the NPPES registry weekly; last sync: September 13, 2026.

Record update history: Aug 31, 2026, Jun 12, 2023 (2 updates tracked since 2023).

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About Kevin Nickerson Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KEVIN NICKERSON MD (NPI 1871277970) is an individual family medicine provider in Girard, Pennsylvania, licensed in Pennsylvania (MD497149) and active in the NPI registry since June 2023. He maintains a secondary practice location in Erie.

NPPES Registry Identity

NPI1871277970

Entity TypeIndividualMale

Primary Taxonomy207Q00000X

Provider Legal NameKEVIN NICKERSONCredential: MD

Location Address5165 IMPERIAL PKWYGirard, PA 16417-9524

Mailing Address2314 Sassafras Street, 2nd FloorErie, PA 16502-2721 · (412) 325-5808 · Fax (814) 452-7005

Phone(814) 774-3128

Fax(814) 774-0915

Sole ProprietorNo

Enumeration DateJune 12, 2023

Last NPPES UpdateAugust 31, 20262 updates tracked since enumeration

NPPES CertifiedAugust 31, 2026

✔ NPI 1871277970 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in PA · MD497149

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

5165 IMPERIAL PKWY, Girard, PA 16417

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Secondary Practice Location 1

Location 1232 W 25th StErie, PA 16544-0002 · Phone (814) 452-5000

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. JOSHUA CZERWINSKI D.O.

Family Medicine