Kristopher Wade Wakefield, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

Practice address

448 Cole St
Bushnell, IL 61422-1540

Phone

(309) 772-2317

Fax

(309) 772-2317

NPI assigned

Jul 11, 2006

Last updated

Oct 1, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Specialty

Chiropractic

Education

Northwestern College of Chiropractic, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bakke Chiropractic Clinic SCGroup PAC ID 6002864501, 10 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Bakke Chiropractic Clinic SC

  • Chiropractor
  • Deforest, WI
  • NPI 1306915079
  Medicare reassignment Care Compare group NPD
• Bushnell Chiropractic Center SC

  • Chiropractor
  • Bushnell, IL
  • NPI 1790806636
  NPD (past) Authorized official

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191196800000",
    "number": "1154356285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "448 COLE ST",
            "city": "BUSHNELL",
            "state": "IL",
            "postal_code": "614221540",
            "telephone_number": "309-772-2317",
            "fax_number": "309-772-2317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "448 COLE ST",
            "city": "BUSHNELL",
            "state": "IL",
            "postal_code": "614221540",
            "telephone_number": "309-772-2317",
            "fax_number": "309-772-2317"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAKEFIELD",
        "first_name": "KRISTOPHER",
        "middle_name": "WADE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-11",
        "last_updated": "2007-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": null,
            "primary": true
        },
        {
            "code": "111NR0200X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Radiology",
            "state": "IL",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS NUMBER",
            "identifier": "5522061",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hawk Intelligence LLC
• Kellie Sue Jones, FNP-C
• Cynthia Paige McCord, DDS
• McDonough County Hospital District (Bushnell Family Practice)
• Abigail Thompson, CF-SLP

• Chiropractor in Bushnell, IL
• Providers in Bushnell, IL by specialty
• Chiropractor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2007; 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.