NPIMap

Individual provider Active NPI

Flynn J Vick, DC

  • Chiropractor
  • Hayden, ID
National Provider Identifier
1891139218
Registry record updated Jul 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIA-1551 Issued in ID
Practice address
8475 N Government Way
103
Hayden, ID 83835-8670
Phone
(406) 581-4240
NPI assigned
Apr 29, 2013
Last updated
Jul 17, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 17, 2016

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-1551 ID Primary

Addresses

Primary practice location

8475 N Government Way
103
Hayden, ID 83835-8670

Mailing address

8475 N Government Way
103
Hayden, ID 83835-8670
Phone (406) 581-4240

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CHIA-1551IDMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Prochiropractic, PC Chiropractor PastSince Dec 21, 2015 Accepting new patients
Col323 PLLC Chiropractor Past 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": "1367193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468713600000",
    "number": "1891139218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8475 N GOVERNMENT WAY",
            "address_2": "103",
            "city": "HAYDEN",
            "state": "ID",
            "postal_code": "838358670",
            "telephone_number": "406-581-4240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8475 N GOVERNMENT WAY",
            "address_2": "103",
            "city": "HAYDEN",
            "state": "ID",
            "postal_code": "838358670",
            "telephone_number": "406-581-4240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VICK",
        "first_name": "FLYNN",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-04-29",
        "last_updated": "2016-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "ID",
            "license": "CHIA-1551",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hayden, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.