Individual provider Active NPI

Skyler Madison Fodor, DC

  • Chiropractor
  • Sunnyside, WA
National Provider Identifier
1245911502
Registry record updated Jul 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH61465639 Issued in WA
Practice address
1724 Wesley Way
Sunnyside, WA 98944-6001
Phone
(509) 839-0000
NPI assigned
Jul 28, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 28, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH61465639 WA Primary

Addresses

Primary practice location

1724 Wesley Way
Sunnyside, WA 98944-6001

Mailing address

451 E Allen Rd
Sunnyside, WA 98944-9124
Phone (937) 344-5777

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230901002915 WA Practitioner - Chiropractic 8820451149 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fodor Chiropractic PSGroup PAC ID 1658431838, 3 clinicians

Practice addresses (Care Compare)

1724 Wesley Way
Sunnyside, WA 98944-6001
Phone 5098402113402113

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Fodor Chiropractic P.S. Chiropractor CurrentSince Aug 18, 2023 Accepting new patients

Locations

1724 Wesley Way
Sunnyside, WA 98944
Phone (509) 839-5656

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": "1690502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690502400000",
    "number": "1245911502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "451 E ALLEN RD",
            "city": "SUNNYSIDE",
            "state": "WA",
            "postal_code": "989449124",
            "telephone_number": "937-344-5777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1724 WESLEY WAY",
            "city": "SUNNYSIDE",
            "state": "WA",
            "postal_code": "989446001",
            "telephone_number": "509-839-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FODOR",
        "first_name": "SKYLER",
        "middle_name": "MADISON",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-07-28",
        "last_updated": "2023-07-28",
        "certification_date": "2023-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH61465639",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sunnyside, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2023; 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.