Individual provider Active NPI

Stephen Gary Flikke, DC

  • Chiropractor
  • Hudson, WI
National Provider Identifier
1922185180
Registry record updated Nov 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4440 Issued in MN
Practice address
2501 Hanley Rd Ste 102
Hudson, WI 54016-8705
Phone
(715) 386-4075
Fax
(715) 386-4069
NPI assigned
Nov 1, 2006
Last updated
Nov 13, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4440 MN Primary

Addresses

Primary practice location

2501 Hanley Rd Ste 102
Hudson, WI 54016-8705

Mailing address

2501 Hanley Rd Ste 102
Hudson, WI 54016-8705
Phone (715) 386-4075

Other identifiers 3

IdentifierTypeStateIssuer
254K950OtherMNBLUE CROSS BLUE SHIELD
1922185180MedicaidWI
1700031044OtherWICLINIC NPI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090313000116 WI Practitioner - Chiropractic 0143122424 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Northwestern College of Chiropractic, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2501 Hanley Rd
Suite 102
Hudson, WI 54016-8786
Phone (715) 386-4075

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Stephen G. Flikke D.C. S.C. CurrentSince Dec 26, 2008 Accepting new patients
Flikke Chiropractic PA Chiropractor Past Accepting new patients
Healthsource of Burnsville, P.a. Past Accepting new patients

Locations

2424 Monetary Blvd
Ste 105
Hudson, WI 54016
Phone (715) 386-4075

2501 Hanley Rd
Ste 102
Hudson, WI 54016
Phone (715) 386-4075

Organizations & group practices 3

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": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699833600000",
    "number": "1922185180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2501 HANLEY RD STE 102",
            "city": "HUDSON",
            "state": "WI",
            "postal_code": "540168705",
            "telephone_number": "715-386-4075",
            "fax_number": "715-386-4069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 HANLEY RD STE 102",
            "city": "HUDSON",
            "state": "WI",
            "postal_code": "540168705",
            "telephone_number": "715-386-4075",
            "fax_number": "715-386-4069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLIKKE",
        "first_name": "STEPHEN",
        "middle_name": "GARY",
        "name_prefix": "Mr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2023-11-13",
        "certification_date": "2023-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "4440",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "254K950",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1922185180",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLINIC NPI",
            "identifier": "1700031044",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hudson, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2023; 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.