Individual provider Active NPI

Bryan Russell Hickam, DC

  • Chiropractor
  • Bozeman, MT
National Provider Identifier
1053104067
Registry record updated May 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHI-CHI-LIC-9409 Issued in MT
Practice address
2405 W Main St Ste 8
Bozeman, MT 59718-3978
Phone
(406) 219-2462
NPI assigned
May 23, 2025
Last updated
May 23, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CHI-CHI-LIC-9409 MT Primary

Addresses

Primary practice location

2405 W Main St Ste 8
Bozeman, MT 59718-3978

Mailing address

8757 Jackrabbit LN Ste a
Belgrade, MT 59714-8994
Phone (406) 388-9915

Other practice location 1

8757 Jackrabbit Ln Ste A
Belgrade, MT 59714-8994
Phone (406) 388-9915

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260604000129 MT Practitioner - Chiropractic 6901377654 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Chiropractic Health Associates PLLCGroup PAC ID 2860446309, 3 clinicians

Practice addresses (Care Compare)

1407 Wyoming Ave
Billings, MT 59102-5301
Phone (406) 656-3333

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CHI-CHI-LIC-9409MTMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Tru Chiropractic Chiropractor CurrentSince May 25, 2025 Accepting new patients

Locations

2405 W Main St
Ste 8
Bozeman, MT 59718
Phone (406) 219-2462

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1747958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747958400000",
    "number": "1053104067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8757 JACKRABBIT LN STE A",
            "city": "BELGRADE",
            "state": "MT",
            "postal_code": "597148994",
            "telephone_number": "406-388-9915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2405 W MAIN ST STE 8",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597183978",
            "telephone_number": "406-219-2462"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8757 Jackrabbit Ln Ste A",
            "address_purpose": "LOCATION",
            "city": "Belgrade",
            "state": "MT",
            "postal_code": "597148994",
            "country_code": "US",
            "telephone_number": "406-388-9915",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HICKAM",
        "first_name": "BRYAN",
        "middle_name": "RUSSELL",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-05-23",
        "last_updated": "2025-05-23",
        "certification_date": "2025-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MT",
            "license": "CHI-CHI-LIC-9409",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bozeman, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.