Individual provider Active NPI

Justin Hildebrand, DC

  • Chiropractor
  • Kansas City, MO
National Provider Identifier
1669776365
Registry record updated Nov 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2011000585 Issued in MO
Practice address
6443 N Cosby Ave
Kansas City, MO 64151
Phone
(816) 584-0413
Fax
(816) 584-0453
NPI assigned
Jan 10, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2011000585 MO Primary

Addresses

Primary practice location

6443 N Cosby Ave
Kansas City, MO 64151

Mailing address

6443 N Cosby Ave
Kansas City, MO 64151
Phone (816) 584-0413

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110321000551 MO Practitioner - Chiropractic 7719160381 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Cleveland Chiropractic College - Kansas City, 2010
Medicare assignment
May accept Medicare assignment
Group practices
Casey Hildebrand Chiropractic Services LLCGroup PAC ID 6305183534, 2 clinicians

Practice addresses (Care Compare)

8303 N Congress Ave
Kansas City, MO 64152-2041
Phone (816) 584-0413

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2011000585MOMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Casey Hildebrand Chiropractic Services LLC Chiropractor CurrentSince Dec 19, 2018 Accepting new patients

Locations

6443 N Cosby Ave
Kansas City, MO 64151
Phone (816) 584-0413

8303 N Congress Ave
Kansas City, MO 64152
Phone (816) 584-0413

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.

NPI Registry JSON

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

{
    "created_epoch": "1294617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731628800000",
    "number": "1669776365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6443 N COSBY AVE",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "64151",
            "telephone_number": "816-584-0413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6443 N COSBY AVE",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "64151",
            "telephone_number": "816-584-0413",
            "fax_number": "816-584-0453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HILDEBRAND",
        "first_name": "JUSTIN",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-01-10",
        "last_updated": "2024-11-15",
        "certification_date": "2020-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "2011000585",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2024; 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.