Active NPI
Marvin Keron Vickers III, D.C.
- Chiropractor
- Birmingham, AL
National Provider Identifier
1639227481
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 1933
- Practice address
- 3940 Grants Mill Rd
Birmingham, AL 35210-1204 - Phone
- (205) 951-2204
- Fax
- (205) 951-2242
- NPI assigned
- Jan 8, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 1933 | AL | Primary |
Addresses
Primary practice location
3940 Grants Mill Rd
Birmingham, AL 35210-1204
Mailing address
6005 Ridge TRL
Birmingham, AL 35242
Phone (205) 995-0340
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| U80955 | Other | AL | VIVA |
| 4410443 | Other | AL | UNITED HEALTHCARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AL
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Life Chiropractic College, 1999
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
3940 Kilgore Memorial Dr
Irondale, AL 35210-5000
Phone (205) 951-2204
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
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.
-
- Chiropractor
- Birmingham, AL
- NPI 1942556576
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168214400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1639227481",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6005 RIDGE TRL",
"city": "BIRMINGHAM",
"state": "AL",
"postal_code": "35242",
"telephone_number": "205-995-0340"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3940 GRANTS MILL RD",
"city": "BIRMINGHAM",
"state": "AL",
"postal_code": "352101204",
"telephone_number": "205-951-2204",
"fax_number": "205-951-2242"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VICKERS",
"first_name": "MARVIN",
"middle_name": "KERON",
"name_prefix": "Dr.",
"name_suffix": "III",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-08",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "AL",
"license": "1933",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VIVA",
"identifier": "U80955",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE",
"identifier": "4410443",
"state": "AL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Birmingham, AL
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.