Individual provider Active NPI

Parker Paul McKittrick, DC

  • Chiropractor
  • West Fargo, ND
National Provider Identifier
1639715303
Registry record updated Nov 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1115 Issued in ND
Practice address
1207 Prairie Pkwy Ste a
West Fargo, ND 58078-3145
Phone
(701) 492-0696
NPI assigned
Nov 18, 2019
Last updated
Nov 18, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1115 ND Primary

Addresses

Primary practice location

1207 Prairie Pkwy Ste a
West Fargo, ND 58078-3145

Mailing address

1207 Prairie Pkwy Ste a
West Fargo, ND 58078-3145
Phone (701) 492-0696

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191223000892 ND Practitioner - Chiropractic 3072947217 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2019
Medicare assignment
May accept Medicare assignment
Group practices
Clinic FHSC PCGroup PAC ID 8628088820, 4 clinicians

Practice addresses (Care Compare)

1207 Prairie Pkwy
West Fargo, ND 58078-3145
Phone (701) 492-0696

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1115NDMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Clinic FHSC PC CurrentSince Nov 18, 2019 Accepting new patients
Dr. J Gregory Dye, P.C. CurrentSince Nov 18, 2019 Accepting new patients

Organizations & group practices 2

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": "1574035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574035200000",
    "number": "1639715303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1207 PRAIRIE PKWY STE A",
            "city": "WEST FARGO",
            "state": "ND",
            "postal_code": "580783145",
            "telephone_number": "701-492-0696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1207 PRAIRIE PKWY STE A",
            "city": "WEST FARGO",
            "state": "ND",
            "postal_code": "580783145",
            "telephone_number": "701-492-0696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKITTRICK",
        "first_name": "PARKER",
        "middle_name": "PAUL",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-11-18",
        "last_updated": "2019-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "ND",
            "license": "1115",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Fargo, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2019; 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.