Individual provider Active NPI

Rikke Johansen, DC

  • Sports Physician Chiropractor
  • Palo Alto, CA
National Provider Identifier
1124079397
Registry record updated Feb 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Physician ChiropractorTaxonomy code 111NS0005X
License
DC22727 Issued in CA
Practice address
609 Cowper St
Palo Alto, CA 94301-1808
Phone
(650) 484-0110
Fax
(650) 644-0110
NPI assigned
May 13, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Physician Chiropractor 111NS0005X DC22727 CA Primary

Addresses

Primary practice location

609 Cowper St
Palo Alto, CA 94301-1808

Mailing address

609 Cowper St
Palo Alto, CA 94301-1808
Phone (650) 484-0110

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190301000711 CA Practitioner - Chiropractic 0446262323 Reassigns benefits to 1 organization
Practice locations: Redwood City, CA

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - West Sunnyvale, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rikke Chiropractic PCGroup PAC ID 8123548179, 2 clinicians

Practice addresses (Care Compare)

609 Cowper St
Palo Alto, CA 94301-1808
Phone (650) 484-0110

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC22727CAMDSports Physician Chiropractor
22727CAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Mobilize Sports Chiropractic and Manual Therapy, Inc. Sports Physician CurrentSince Feb 16, 2019 Accepting new patients
Rikke Chiropractic PC Sports Physician CurrentSince Jan 16, 2025 Accepting new patients
Health Logic, LLC Sports Physician Past Accepting new patients
Lucas Physical Therapy and Fitness Inc PastSince Feb 23, 2025 Accepting new patients

Locations

609 Cowper St
Palo Alto, CA 94301
Phone (408) 774-1424

536 El Camino Real
Redwood City, CA 94063
Phone (650) 853-1800

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1147478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739491200000",
    "number": "1124079397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "609 COWPER ST",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943011808",
            "telephone_number": "650-484-0110",
            "fax_number": "650-644-0110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "609 COWPER ST",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943011808",
            "telephone_number": "650-484-0110",
            "fax_number": "650-644-0110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHANSEN",
        "first_name": "RIKKE",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-13",
        "last_updated": "2025-02-14",
        "certification_date": "2025-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "CA",
            "license": "DC22727",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palo Alto, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 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.