Individual provider Active NPI

Casey Chadd Vidricksen, D.C.

  • Chiropractor
  • Salina, KS
National Provider Identifier
1619995362
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
01-04754 Issued in KS
Practice address
935 Elmhurst Blvd
Salina, KS 67401-7401
Phone
(785) 823-8085
NPI assigned
Jul 18, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 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 01-04754 KS Primary

Addresses

Primary practice location

935 Elmhurst Blvd
Salina, KS 67401-7401

Mailing address

935 Elmhurst Blvd
Salina, KS 67401-7401
Phone (785) 823-8085

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050622000566 KS Practitioner - Chiropractic 3870538630 Practice locations: Salina, KS

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Cleveland Chiropractic College - Kansas City, 2001
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

935 Elmhurst Blvd
Salina, KS 67401-7401
Phone (785) 823-8092

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1619995362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "935 ELMHURST BLVD",
            "city": "SALINA",
            "state": "KS",
            "postal_code": "674017401",
            "telephone_number": "785-823-8085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "935 ELMHURST BLVD",
            "city": "SALINA",
            "state": "KS",
            "postal_code": "674017401",
            "telephone_number": "785-823-8085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIDRICKSEN",
        "first_name": "CASEY",
        "middle_name": "CHADD",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "KS",
            "license": "01-04754",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salina, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.