Individual provider Active NPI

Patrick J. Hickman, D.C.

  • Nutrition Chiropractor
  • Moses Lake, WA
National Provider Identifier
1629187216
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nutrition ChiropractorTaxonomy code 111NN1001X
License
CH00002107 Issued in WA
Practice address
312 S. Balsam St.
Ste a
Moses Lake, WA 98837
Phone
(509) 766-1283
Fax
(509) 766-0306
NPI assigned
Aug 29, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

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
Nutrition Chiropractor 111NN1001X CH00002107 WA Primary

Addresses

Primary practice location

312 S. Balsam St.
Ste a
Moses Lake, WA 98837

Mailing address

312 S Balsam St Ste a
Moses Lake, WA 98837-1796
Phone (509) 766-1283

Other names 1

  • Dr. Patrick J. Hickman Professional name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110315001088 WA Practitioner - Chiropractic 9032391818 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - West Sunnyvale, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

312 S Balsam St a
Moses Lake, WA 98837-1796
Phone (509) 766-1293

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Patrick J. Hickman D.C.P.S. CurrentSince Jan 1, 2003 Accepting new patients

Locations

312 S Balsam St
Ste A
Moses Lake, WA 98837
Phone (509) 766-1283

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1629187216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "312 S BALSAM ST STE A",
            "city": "MOSES LAKE",
            "state": "WA",
            "postal_code": "988371796",
            "telephone_number": "509-766-1283",
            "fax_number": "509-766-0306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "312 S. BALSAM ST.",
            "address_2": "STE A",
            "city": "MOSES LAKE",
            "state": "WA",
            "postal_code": "98837",
            "telephone_number": "509-766-1283",
            "fax_number": "509-766-0306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HICKMAN",
        "first_name": "PATRICK",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NN1001X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Nutrition",
            "state": "WA",
            "license": "CH00002107",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PATRICK",
            "last_name": "HICKMAN",
            "middle_name": "J.",
            "prefix": "DR.",
            "credential": "D.C.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Moses Lake, WA

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.