Individual provider Active NPI

Ty Charles Quickenden, D.C.

  • Chiropractor
  • Rock Springs, WY
National Provider Identifier
1588720684
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
589 Issued in WY
Practice address
2632 Foothill Blvd
Suite 107
Rock Springs, WY 82901-4756
Phone
(307) 362-7900
Fax
(307) 362-8230
NPI assigned
Dec 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 589 WY Primary

Addresses

Primary practice location

2632 Foothill Blvd
Suite 107
Rock Springs, WY 82901-4756

Mailing address

525 Emerald St
Rock Springs, WY 82901-6740
Phone (307) 362-0943

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050113000914 WY Practitioner - Chiropractic 5294784641 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - West Sunnyvale, 1999
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2632 Foothill Blvd
Suite 107
Rock Springs, WY 82901-4757
Phone (307) 362-7900

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
589WYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Ty C. Quickenden Chiropractic, P.C. Chiropractor CurrentSince Sep 27, 2004 Accepting new patients

Locations

2632 Foothill Blvd
Ste 107
Rock Springs, WY 82901
Phone (307) 362-7900

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": "1167523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1588720684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 EMERALD ST",
            "city": "ROCK SPRINGS",
            "state": "WY",
            "postal_code": "829016740",
            "telephone_number": "307-362-0943",
            "fax_number": "307-362-8230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2632 FOOTHILL BLVD",
            "address_2": "SUITE 107",
            "city": "ROCK SPRINGS",
            "state": "WY",
            "postal_code": "829014756",
            "telephone_number": "307-362-7900",
            "fax_number": "307-362-8230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUICKENDEN",
        "first_name": "TY",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-31",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WY",
            "license": "589",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rock Springs, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.