Individual provider Active NPI

Stephen Charles Wilks, D.C.

  • Chiropractor
  • Jackson, TN
National Provider Identifier
1851323190
Registry record updated Sep 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1777 Issued in TN
Practice address
7 Stonebridge Blvd
Suite a
Jackson, TN 38305-2021
Phone
(731) 664-5550
Fax
(731) 664-5990
NPI assigned
Jul 7, 2006
Last updated
Sep 10, 2013By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 10, 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 1777 TN Primary

Addresses

Primary practice location

7 Stonebridge Blvd
Suite a
Jackson, TN 38305-2021

Mailing address

28 Belle Trace CV
Jackson, TN 38305-3570
Phone (731) 664-5550

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120120000497 TN Practitioner - Chiropractic 4587831284 Practice locations: Jackson, TN

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

7 A Stonebridge Blvd
Jackson, TN 38305-2021
Phone (731) 664-5550

7 Stonebridge Blvd
Suite a
Jackson, TN 38305-2021

7 Stonebridge Blvd a
Jackson, TN 38305-2021

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1777TNMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Norris Chiropractic PLLC Chiropractor Past Accepting new patients
Wilks Chiropractic Center, PLLC Chiropractor PastSince Nov 13, 2000 Accepting new patients

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": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378771200000",
    "number": "1851323190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28 BELLE TRACE CV",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383053570",
            "telephone_number": "731-664-5550",
            "fax_number": "731-664-5990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 STONEBRIDGE BLVD",
            "address_2": "SUITE A",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383052021",
            "telephone_number": "731-664-5550",
            "fax_number": "731-664-5990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILKS",
        "first_name": "STEPHEN",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2013-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TN",
            "license": "1777",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 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.