Individual provider Active NPI

Amanda E. Hickman, D.C.

  • Chiropractor
  • Kansas City, MO
National Provider Identifier
1205086444
Registry record updated Oct 29, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2013004098 Issued in MO
Practice address
5910 NW 63Rd Ter
Kansas City, MO 64151-3319
Phone
(816) 216-1218
Fax
(816) 216-1633
NPI assigned
Sep 24, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2013004098 MO Primary

Addresses

Primary practice location

5910 NW 63Rd Ter
Kansas City, MO 64151-3319

Mailing address

5910 NW 63Rd Ter
Kansas City, MO 64151-3319
Phone (816) 216-1218

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130514000343 MO Practitioner - Chiropractic 4880762293 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Cleveland Chiropractic College - Kansas City, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Living Balance Chiropractic and AcupunctureGroup PAC ID 3678710589, 2 clinicians

Practice addresses (Care Compare)

5775 NW 64TH Ter
Suite 101
Kansas City, MO 64151-3945
Phone (816) 216-1218

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2013004098MOMDChiropractor

Organizations & group practices 1

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": "1222214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383004800000",
    "number": "1205086444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5910 NW 63RD TER",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641513319",
            "telephone_number": "816-216-1218",
            "fax_number": "816-216-1633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5910 NW 63RD TER",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641513319",
            "telephone_number": "816-216-1218",
            "fax_number": "816-216-1633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HICKMAN",
        "first_name": "AMANDA",
        "middle_name": "E.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-24",
        "last_updated": "2013-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "2013004098",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2013; 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.