Individual provider Active NPI

Cody Wilhelm, DC

  • Chiropractor
  • Twin Falls, ID
National Provider Identifier
1811519838
Registry record updated Jun 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIA-2005 Issued in ID
Practice address
1505 Madrona St N # 900C
Twin Falls, ID 83301-8318
Phone
(208) 203-3155
NPI assigned
May 13, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CHIA-2005 ID Primary

Addresses

Primary practice location

1505 Madrona St N # 900C
Twin Falls, ID 83301-8318

Mailing address

29 Canyon View Rd
Jerome, ID 83338-6012
Phone (208) 203-3155

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200624001430 ID Practitioner - Chiropractic 6800218678 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2020
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1505 Madrona St N
900C
Twin Falls, ID 83301-8318
Phone (208) 203-3102

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CHIA-2005IDMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Wilhelm Chiropractic LLC Chiropractor CurrentSince Jun 1, 2020 Accepting new patients

Locations

1505 Madrona St N
#900C
Twin Falls, ID 83301
Phone (208) 203-3102

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": "1589328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591228800000",
    "number": "1811519838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29 CANYON VIEW RD",
            "city": "JEROME",
            "state": "ID",
            "postal_code": "833386012",
            "telephone_number": "208-203-3155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1505 MADRONA ST N # 900C",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833018318",
            "telephone_number": "208-203-3155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILHELM",
        "first_name": "CODY",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-05-13",
        "last_updated": "2020-06-04",
        "certification_date": "2020-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "ID",
            "license": "CHIA-2005",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Twin Falls, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2020; 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.