Individual provider Active NPI

Craig Bruce Hediger, DC

  • Chiropractor
  • Wasilla, AK
National Provider Identifier
1750339644
Registry record updated Oct 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
138 Issued in AK
Practice address
101 W Parks Hwy
Wasilla, AK 99654
Phone
(907) 376-4851
Fax
(907) 373-4851
NPI assigned
May 4, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 9, 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 138 AK Primary

Addresses

Primary practice location

101 W Parks Hwy
Wasilla, AK 99654

Mailing address

101 W Parks Hwy
Wasilla, AK 99654
Phone (907) 376-4851

Other identifiers 1

IdentifierTypeStateIssuer
CH0074MedicaidAK

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060403000056 AK Practitioner - Chiropractic 0941218986 Practice locations: Wasilla, AK

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
New York Chiropractic College, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

101 W Parks Hwy
Wasilla, AK 99654-6918

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
138AKMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Wasilla Chiropractic Clinic Chiropractor CurrentSince Jan 1, 1990 Accepting new patients

Locations

101 W Parks Hwy
Wasilla, AK 99654
Phone (907) 376-4851

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": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191888000000",
    "number": "1750339644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 W PARKS HWY",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "99654",
            "telephone_number": "907-376-4851",
            "fax_number": "907-373-4851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 W PARKS HWY",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "99654",
            "telephone_number": "907-376-4851",
            "fax_number": "907-373-4851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEDIGER",
        "first_name": "CRAIG",
        "middle_name": "BRUCE",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-04",
        "last_updated": "2007-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AK",
            "license": "138",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "CH0074",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wasilla, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 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.