Individual provider Active NPI

Christopher Lowe Hicklin, DC

  • Chiropractor
  • Sarasota, FL
National Provider Identifier
1760476816
Registry record updated Oct 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH3772 Issued in FL
Practice address
3220 Clark Rd
Sarasota, FL 34231-8302
Phone
(941) 923-4357
Fax
(941) 923-9943
NPI assigned
Sep 6, 2005
Last updated
Oct 4, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH3772 FL Primary

Addresses

Primary practice location

3220 Clark Rd
Sarasota, FL 34231-8302

Mailing address

3220 Clark Rd
Sarasota, FL 34231-8302
Phone (941) 923-4357

Other identifiers 2

IdentifierTypeStateIssuer
88736YOtherFLMEDICARE PTAN
26-1512892OtherFLTID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH3772FLMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Kondrad Chiropractic LLC Chiropractor CurrentSince Oct 1, 2019 Accepting new patients

Locations

3220 Clark Rd
Sarasota, FL 34231
Phone (941) 923-4357

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1125964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317686400000",
    "number": "1760476816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3220 CLARK RD",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342318302",
            "telephone_number": "941-923-4357",
            "fax_number": "941-923-9943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3220 CLARK RD",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342318302",
            "telephone_number": "941-923-4357",
            "fax_number": "941-923-9943"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HICKLIN",
        "first_name": "CHRISTOPHER",
        "middle_name": "LOWE",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-06",
        "last_updated": "2011-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH3772",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "88736Y",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TID",
            "identifier": "26-1512892",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sarasota, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.