Individual provider Active NPI

Brian E Wickert, D.C.

  • Chiropractor
  • Hanford, CA
National Provider Identifier
1730262361
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
19332 Issued in CA
Practice address
612 N Douty St
Hanford, CA 93230-3913
Phone
(559) 584-7991
Fax
(559) 584-2551
NPI assigned
Oct 24, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 19332 CA Primary

Addresses

Primary practice location

612 N Douty St
Hanford, CA 93230-3913

Mailing address

612 N Douty St
Hanford, CA 93230-3913
Phone (559) 584-7991

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111205000802 CA Practitioner - Chiropractic 5496920340 Practice locations: Hanford, CA

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - West Sunnyvale, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

612 N Douty St
Hanford, CA 93230-3913
Phone (559) 584-7991

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
19332CAMDPsychiatry Physician

NPI Registry JSON

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1730262361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "612 N DOUTY ST",
            "city": "HANFORD",
            "state": "CA",
            "postal_code": "932303913",
            "telephone_number": "559-584-7991",
            "fax_number": "559-584-2551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "612 N DOUTY ST",
            "city": "HANFORD",
            "state": "CA",
            "postal_code": "932303913",
            "telephone_number": "559-584-7991",
            "fax_number": "559-584-2551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WICKERT",
        "first_name": "BRIAN",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "19332",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hanford, CA

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.

Verify at the official NPI Registry.