Individual provider Active NPI

Adam G Wilkerson, DC

  • Chiropractor
  • Kansas City, MO
National Provider Identifier
1417455486
Registry record updated Jan 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2018001066 Issued in MO
Practice address
7900 Lees Summit Rd
Kansas City, MO 64139-1236
Phone
(816) 404-9120
Fax
(816) 404-9122
NPI assigned
Jan 24, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2018001066 MO Primary

Addresses

Primary practice location

7900 Lees Summit Rd
Kansas City, MO 64139-1236

Mailing address

19550 E 39TH St S Ste 235
Independence, MO 64057-2305
Phone (816) 795-5300

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180226000863 MO Practitioner - Chiropractic 1850652363 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Myocore LLCGroup PAC ID 9830267277, 30 clinicians

Practice addresses (Care Compare)

7900 Lees Summit Rd
Kansas City, MO 64139-1236
Phone (816) 404-9120

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2018001066MOMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Myocore, LLC Chiropractor CurrentSince Feb 12, 2018 Accepting new patients

Locations

2625 Butterfield Rd
Ste 301N
Oak Brook, IL 60523
Phone (800) 613-0922

19550 E 39th St S
Ste 235
Independence, MO 64057
Phone (816) 795-5300

7900 Lees Summit Rd
Kansas City, MO 64139
Phone (816) 373-4485

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": "1516752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1516752000000",
    "number": "1417455486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19550 E 39TH ST S STE 235",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "640572305",
            "telephone_number": "816-795-5300",
            "fax_number": "816-795-5305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7900 LEES SUMMIT RD",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641391236",
            "telephone_number": "816-404-9120",
            "fax_number": "816-404-9122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILKERSON",
        "first_name": "ADAM",
        "middle_name": "G",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-01-24",
        "last_updated": "2018-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "2018001066",
            "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 Jan 24, 2018; 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.