Organization Active NPI

Wickwire Chiropractic and Wellness Center P.C.

  • Chiropractor
  • Hiawatha, IA
National Provider Identifier
1669605937
Registry record updated Oct 5, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
007214 Issued in IA
Legal business name
WICKWIRE CHIROPRACTIC AND WELLNESS CENTER P.C.
Practice address
1690 Blairs Ferry Rd
Hiawatha, IA 52233
Phone
(319) 393-3345
NPI assigned
Sep 2, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2009

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

Authorized official

Name
Dr. Lee A Wickwire, D.C.NPI 1861622292
Title
President
Phone
(319) 393-3345

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 007214 IA Primary

Addresses

Primary practice location

1690 Blairs Ferry Rd
Hiawatha, IA 52233

Mailing address

1690 Blairs Ferry Rd
Hiawatha, IA 52233
Phone (319) 393-3345

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091005000415 IA Part B Supplier - Clinic/Group Practice 2567508526 Receives reassigned benefits from 4 practitioners
Practice locations: Hiawatha, IA

National Provider Directory

National Provider Directory

Locations

1690 Blairs Ferry Rd
Hiawatha, IA 52233
Phone (319) 210-4430

955 29th Ave
Ste B
Marion, IA 52302
Phone (319) 449-4874

555 W Cherry St
Ste 2
North Liberty, IA 52317
Phone (319) 393-3345

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1251849600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1254700800000",
    "number": "1669605937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1690 BLAIRS FERRY RD",
            "city": "HIAWATHA",
            "state": "IA",
            "postal_code": "52233",
            "telephone_number": "319-393-3345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1690 BLAIRS FERRY RD",
            "city": "HIAWATHA",
            "state": "IA",
            "postal_code": "52233",
            "telephone_number": "319-393-3345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WICKWIRE CHIROPRACTIC AND WELLNESS CENTER P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-02",
        "last_updated": "2009-10-05",
        "status": "A",
        "authorized_official_last_name": "WICKWIRE",
        "authorized_official_first_name": "LEE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "319-393-3345",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "IA",
            "license": "007214",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hiawatha, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.