Individual provider Active NPI

Warner Martin Hettick, D.C.

  • Chiropractor
  • Westminster, CO
National Provider Identifier
1134445984
Registry record updated Nov 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH60141578 Issued in WA
Practice address
12061 Tejon St Ste 600
Westminster, CO 80234-2325
Phone
(303) 457-0123
Fax
(303) 252-4065
NPI assigned
Apr 19, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 9, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH60141578 WA Primary

Addresses

Primary practice location

12061 Tejon St Ste 600
Westminster, CO 80234-2325

Mailing address

12061 Tejon St Ste 600
Westminster, CO 80234-2325
Phone (303) 457-0123

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150107001964 CO Practitioner - Chiropractic 9931230489 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Western States College of Chiropractic, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Spine Group LLCGroup PAC ID 5698938298, 2 clinicians

Practice addresses (Care Compare)

12061 Tejon St
Suite 600
Westminster, CO 80234-2325
Phone (303) 457-0123

2205 W 136TH Ave
Suite 112
Broomfield, CO 80023-9306

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Spine Group LLC Chiropractor CurrentSince Aug 18, 2014 Accepting new patients
Mile High Diabetes Vein and Wound Center LLC CurrentSince Mar 29, 2023 Accepting new patients
Mile High Spine and Pain Center LLC PastSince Jan 1, 2025 Accepting new patients
Dynamic Chiropractic Clinic of Bellevue PLLC Chiropractor PastSince Sep 1, 2004 Accepting new patients

Locations

2205 W 136th Ave
Ste 112
Broomfield, CO 80023
Phone (303) 457-0123

12061 Tejon St
Ste 600
Westminster, CO 80234
Phone (303) 457-0123

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": "1271635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604880000000",
    "number": "1134445984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12061 TEJON ST STE 600",
            "city": "WESTMINSTER",
            "state": "CO",
            "postal_code": "802342325",
            "telephone_number": "303-457-0123",
            "fax_number": "303-252-4065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12061 TEJON ST STE 600",
            "city": "WESTMINSTER",
            "state": "CO",
            "postal_code": "802342325",
            "telephone_number": "303-457-0123",
            "fax_number": "303-252-4065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HETTICK",
        "first_name": "WARNER",
        "middle_name": "MARTIN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-04-19",
        "last_updated": "2020-11-09",
        "certification_date": "2020-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH60141578",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westminster, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2020; 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.