NPIMap

Organization Active NPI

Wicked Good Chiropractic & Wellness Group, PC

  • Chiropractor
  • Mansfield, MA
National Provider Identifier
1871067124
Registry record updated Jan 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
WICKED GOOD CHIROPRACTIC & WELLNESS GROUP, PC
Practice address
77 West St Ste a
Mansfield, MA 02048-2403
Phone
(508) 339-1418
Fax
(774) 284-4927
NPI assigned
Jan 18, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2024

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

Authorized official

Name
Dr. Sarah Ann Corcoran, DCNPI 1174692743
Title
President
Phone
(508) 339-1418

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X Primary
AcupuncturistGroup: 193200000X MULTI-SPECIALTY GROUP 171100000X
Massage TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225700000X

Addresses

Primary practice location

77 West St Ste a
Mansfield, MA 02048-2403

Mailing address

77 West St Ste a
Mansfield, MA 02048-2403
Phone (508) 339-1418

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200207000650 MA Part B Supplier - Clinic/Group Practice 7911333141 Receives reassigned benefits from 3 practitioners
Practice locations: Mansfield, MA

National Provider Directory

National Provider Directory

Locations

77 West St
Ste A
Mansfield, MA 02048
Phone (508) 339-1418

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1547769600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704758400000",
    "number": "1871067124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 WEST ST STE A",
            "city": "MANSFIELD",
            "state": "MA",
            "postal_code": "020482403",
            "telephone_number": "508-339-1418",
            "fax_number": "774-287-9486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 WEST ST STE A",
            "city": "MANSFIELD",
            "state": "MA",
            "postal_code": "020482403",
            "telephone_number": "508-339-1418",
            "fax_number": "774-284-4927"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WICKED GOOD CHIROPRACTIC & WELLNESS GROUP, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-18",
        "last_updated": "2024-01-09",
        "certification_date": "2024-01-09",
        "status": "A",
        "authorized_official_last_name": "CORCORAN",
        "authorized_official_first_name": "SARAH",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "508-339-1418",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "171100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Acupuncturist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Massage Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mansfield, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.