Individual provider Active NPI

Kirk Eriksen, DC

  • Chiropractor
  • Dothan, AL
National Provider Identifier
1710074323
Registry record updated Oct 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1411 Issued in AL
Practice address
2500 Flowers Chapel Rd
Dothan, AL 36305-8300
Phone
(334) 793-7992
Fax
(334) 792-0210
NPI assigned
Oct 6, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 21, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1411 AL Primary

Addresses

Primary practice location

2500 Flowers Chapel Rd
Dothan, AL 36305-8300

Mailing address

102 Sterling Ridge CT
Dothan, AL 36303-9301
Phone (334) 714-5869

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120410000309 AL Practitioner - Chiropractic 0244491736 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2500 Flowers Chapel Rd
Dothan, AL 36305-8300
Phone (334) 793-7992

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1411ALMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Regenerative Medicine of Alabama CurrentSince May 1, 2019 Accepting new patients

Locations

2500 Flowers Chapel Rd
Dothan, AL 36305
Phone (334) 699-4299

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": "1160092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413849600000",
    "number": "1710074323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 STERLING RIDGE CT",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363039301",
            "telephone_number": "334-714-5869",
            "fax_number": "334-671-4941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 FLOWERS CHAPEL RD",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363058300",
            "telephone_number": "334-793-7992",
            "fax_number": "334-792-0210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERIKSEN",
        "first_name": "KIRK",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-06",
        "last_updated": "2014-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AL",
            "license": "1411",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dothan, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2014; 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.