Organization Active NPI

Dodge City Chiropractic, LLC

  • Chiropractor
  • Dodge City, KS
National Provider Identifier
1306248992
Registry record updated Sep 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
01-05380 Issued in KS
Legal business name
DODGE CITY CHIROPRACTIC, LLC
Practice address
210 E Frontview St
Suite C
Dodge City, KS 67801-5071
Phone
(620) 371-6166
Fax
(620) 371-6371
NPI assigned
Sep 25, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2014

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

Authorized official

Name
Shaunnon Flickinger, D.C.NPI 1386941979
Title
Chiropractor
Phone
(620) 390-9707

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 111N00000X 01-05380 KS Primary
ChiropractorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 111N00000X 01-05520 KS

Addresses

Primary practice location

210 E Frontview St
Suite C
Dodge City, KS 67801-5071

Mailing address

210 E Frontview St
Suite C
Dodge City, KS 67801-5071
Phone (620) 371-6166

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20141013001146 KS Part B Supplier - Clinic/Group Practice 6002036142 Receives reassigned benefits from 3 practitioners
Practice locations: Dodge City, KS

National Provider Directory

National Provider Directory

Locations

210 E Frontview St
Ste C
Dodge City, KS 67801
Phone (620) 371-6166

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1411603200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1411603200000",
    "number": "1306248992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 E FRONTVIEW ST",
            "address_2": "SUITE C",
            "city": "DODGE CITY",
            "state": "KS",
            "postal_code": "678015071",
            "telephone_number": "620-371-6166",
            "fax_number": "620-371-6371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 E FRONTVIEW ST",
            "address_2": "SUITE C",
            "city": "DODGE CITY",
            "state": "KS",
            "postal_code": "678015071",
            "telephone_number": "620-371-6166",
            "fax_number": "620-371-6371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DODGE CITY CHIROPRACTIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-25",
        "last_updated": "2014-09-25",
        "status": "A",
        "authorized_official_last_name": "FLICKINGER",
        "authorized_official_first_name": "SHAUNNON",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "620-390-9707",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "KS",
            "license": "01-05380",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "KS",
            "license": "01-05520",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dodge City, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.