Individual provider Active NPI

Jennifer Marie Hickey, D.C.

  • Pediatric Chiropractor
  • Hudson, OH
National Provider Identifier
1386940393
Registry record updated May 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric ChiropractorTaxonomy code 111NP0017X
License
1234 Issued in OH
Practice address
5111 Darrow Rd
Hudson, OH 44236-4003
Phone
(330) 618-3070
NPI assigned
Feb 9, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 18, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Chiropractor 111NP0017X 1234 OH Primary

Addresses

Primary practice location

5111 Darrow Rd
Hudson, OH 44236-4003

Mailing address

5111 Darrow Rd
Hudson, OH 44236-4003
Phone (330) 656-1977

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120820000197 OH Practitioner - Chiropractic 5698921054 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
New York Chiropractic College, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

5111 Darrow Rd
Hudson, OH 44236-4003
Phone (330) 656-1977

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1234OHMDFamily Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Bue Chiropractic LLC, Dba the Chiropractic Wellness Center of Hudson CurrentSince Mar 4, 2016 Accepting new patients

Locations

5111 Darrow Rd
Hudson, OH 44236
Phone (330) 655-2668

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": "1297209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684368000000",
    "number": "1386940393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5111 DARROW RD",
            "city": "HUDSON",
            "state": "OH",
            "postal_code": "442364003",
            "telephone_number": "330-656-1977",
            "fax_number": "330-656-1978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5111 DARROW RD",
            "city": "HUDSON",
            "state": "OH",
            "postal_code": "442364003",
            "telephone_number": "330-618-3070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HICKEY",
        "first_name": "JENNIFER",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-02-09",
        "last_updated": "2023-05-18",
        "certification_date": "2022-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NP0017X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Pediatric Chiropractor",
            "state": "OH",
            "license": "1234",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hudson, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 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.