Samantha Kiecker, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

894 Issued in ND

Practice address

1207 Prairie Pkwy
West Fargo, ND 58078

Phone

(701) 492-0696

Fax

(701) 492-0696

NPI assigned

Dec 5, 2011

Last updated

Jul 24, 2014By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ND

Enrollment records 1

Specialty

Chiropractic

Education

Other, 2011

Medicare assignment

May accept Medicare assignment

Group practices

Clinic FHSC PCGroup PAC ID 8628088820, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Clinic FHSC PC

  • Clinic/Center
  • West Fargo, ND
  • NPI 1023286614
  Medicare reassignment Care Compare group NPD
• Dr. J Gregory Dye, P.C.

  dba Family Vision

  • Optometrist
  • West Fargo, ND
  • NPI 1720140577
  NPD

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

{
    "created_epoch": "1323043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1406160000000",
    "number": "1811265903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1207 PRAIRIE PKWY",
            "city": "WEST FARGO",
            "state": "ND",
            "postal_code": "580783145",
            "telephone_number": "701-492-0696",
            "fax_number": "701-492-0696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1207 PRAIRIE PKWY",
            "city": "WEST FARGO",
            "state": "ND",
            "postal_code": "58078",
            "telephone_number": "701-492-0696",
            "fax_number": "701-492-0696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIECKER",
        "first_name": "SAMANTHA",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-12-05",
        "last_updated": "2014-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "ND",
            "license": "894",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gwendolyn R Keller, SLP
• Jennifer Nicole Kelley, MS, ATC, LAT
• Sarah Kennelly, NP
• Sadie Ketteman
• Anne E Kidder, MD
• Ava Kieser
• Deidre Marie Kilde, RN
• Jodi Kilen
• Christina Lynn Kim
• Alison D Kindem, LMT

• Chiropractor in West Fargo, ND
• Providers in West Fargo, ND by specialty
• Chiropractor in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 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.