Individual provider Active NPI

Nathaniel Robert Hiss, DC

  • Chiropractor
  • Fort Wayne, IN
National Provider Identifier
1841484482
Registry record updated Jul 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
08002335A Issued in IN
Practice address
6215 Covington Rd
Fort Wayne, IN 46804-7311
Phone
(260) 755-5953
Fax
(260) 755-5956
NPI assigned
Aug 28, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 15, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 08002335A IN Primary

Addresses

Primary practice location

6215 Covington Rd
Fort Wayne, IN 46804-7311

Mailing address

6215 Covington Rd
Fort Wayne, IN 46804-7311
Phone (260) 755-5953

Other identifiers 2

IdentifierTypeStateIssuer
200877260AMedicaidIN
000000539789OtherINANTHEM

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070912000502 IN Practitioner - Chiropractic 1254424898 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2006
Medicare assignment
May accept Medicare assignment
Group practices
HB Health LLCGroup PAC ID 4688803034, 2 clinicians

Practice addresses (Care Compare)

6215 Covington Rd
Fort Wayne, IN 46804-7311
Phone (260) 755-5953

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
08002335AINMDChiropractor

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": "1188259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1373846400000",
    "number": "1841484482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6215 COVINGTON RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468047311",
            "telephone_number": "260-755-5953",
            "fax_number": "260-755-5956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6215 COVINGTON RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468047311",
            "telephone_number": "260-755-5953",
            "fax_number": "260-755-5956"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HISS",
        "first_name": "NATHANIEL",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-08-28",
        "last_updated": "2013-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IN",
            "license": "08002335A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200877260A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000539789",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2013; 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.