Charles Allen Wickware, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

5612 Issued in TX

Practice address

144 Fairway Dr
Suite D
Kerrville, TX 78028-6455

Phone

(830) 792-4663

Fax

(830) 896-8161

NPI assigned

Oct 24, 2006

Last updated

Jan 11, 2017By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Specialty

Chiropractic

Education

Other, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Peterson Regional Medical Center Hospital, Kerrville, TX, CCN 450007

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Charles a. Wickware Et Al PTR

  dba Home Chiropractic Clinic

  • Chiropractor
  • Kerrville, TX
  • NPI 1073726956
  Medicare reassignment NPD Authorized official

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Sid Peterson Memorial Hospital

  dba Peterson Regional Medical Center

  • Rural Acute Care Hospital
  • Kerrville, TX
  • NPI 1790782704
  Care Compare affiliation

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484092800000",
    "number": "1548344765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "144 FAIRWAY DR",
            "address_2": "SUITE D",
            "city": "KERRVILLE",
            "state": "TX",
            "postal_code": "780286455",
            "telephone_number": "830-792-4663",
            "fax_number": "830-896-8161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "144 FAIRWAY DR",
            "address_2": "SUITE D",
            "city": "KERRVILLE",
            "state": "TX",
            "postal_code": "780286455",
            "telephone_number": "830-792-4663",
            "fax_number": "830-896-8161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WICKWARE",
        "first_name": "CHARLES",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-24",
        "last_updated": "2017-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "5612",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1094575-02",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "84201-BCBS",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR",
            "identifier": "350028968",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kenneth Knox Wheatley Jr., MD
• Renee White, RBT
• Travis Daniel Whitefield
• Whitehead Eye Care PLLC
• Phillip Andrew Whitehead, O.D.
• Jarrod Stirling Wiggins, M.D.
• Linda Susan Wilbourn, LPC
• Karen Renae Wilbrandt, RPH
• M Elizabeth Ruiz Wilfong, D.O.
• William M. Allen,Jr., M.D., P.a.

• Chiropractor in Kerrville, TX
• Providers in Kerrville, TX by specialty
• Chiropractor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2017; 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.