Individual provider Active NPI

Kiersten Mariah Wilcox, DC

  • Chiropractor
  • Ashville, OH
National Provider Identifier
1306441985
Registry record updated Dec 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
05019 Issued in OH
Practice address
3368 State Route 752
Ashville, OH 43103-9009
Phone
(740) 983-3500
NPI assigned
Dec 2, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 2, 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 05019 OH Primary

Addresses

Primary practice location

3368 State Route 752
Ashville, OH 43103-9009

Mailing address

5050 S Walnut St Lot 12
South Bloomfield, OH 43103-1079
Phone (419) 302-7240

Other identifiers 1

IdentifierTypeStateIssuer
05019MedicaidOH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210205000920 OH Practitioner - Chiropractic 8628482445 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2020
Medicare assignment
May accept Medicare assignment
Group practices
Wilcox Family Chiropractic, LLCGroup PAC ID 3577688837, 2 clinicians

Practice addresses (Care Compare)

1233 W Market St
Lima, OH 45805-2728
Phone (419) 229-2225

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
05019OHMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Wilcox Family Chiropractic, LLC Chiropractor CurrentSince Apr 17, 2023 Accepting new patients
Natural Medicine,LLC Chiropractor CurrentSince Jan 1, 2021 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

18 Long St
Ashville, OH 43103
Phone (740) 983-3500

3368 State Route 752
Ashville, OH 43103
Phone (740) 893-3500

1233 W Market St
Lima, OH 45805
Phone (419) 227-8435

529 N Westminster St
Waynesfield, OH 45896
Phone (419) 227-3978

529 N Westminster St
Ste A
Waynesfield, OH 45896

Organizations & group practices 3

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": "1606867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606867200000",
    "number": "1306441985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5050 S WALNUT ST LOT 12",
            "city": "SOUTH BLOOMFIELD",
            "state": "OH",
            "postal_code": "431031079",
            "telephone_number": "419-302-7240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3368 STATE ROUTE 752",
            "city": "ASHVILLE",
            "state": "OH",
            "postal_code": "431039009",
            "telephone_number": "740-983-3500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILCOX",
        "first_name": "KIERSTEN",
        "middle_name": "MARIAH",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-12-02",
        "last_updated": "2020-12-02",
        "certification_date": "2020-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OH",
            "license": "05019",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05019",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ashville, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 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.