Pridham LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

772 Issued in WY

Legal business name

PRIDHAM LLC

Doing business as

Healthsource of Casper

Practice address

426 W 1St St
Casper, WY 82601-2408

Phone

(307) 266-6908

Fax

(307) 266-2583

NPI assigned

Jul 5, 2018

Last updated

Jul 5, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Nina Pridham, DCNPI 1568868453

Title

Owner/Doctor

Phone

(503) 703-6120

Specialties & licenses 1

Addresses

Other names 1

• Healthsource of Casper Doing business as

Medicare fee-for-service enrollment

Enrolled in WY

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Nina Pridham, D.C

  • Chiropractor
  • Casper, WY
  • NPI 1568868453
  Medicare reassignment NPD Authorized official
• David Iszler, DC

  • Chiropractor
  • Glendale, AZ
  • NPI 1730198789
  NPD (past)

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

{
    "created_epoch": "1530748800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1530748800000",
    "number": "1952897712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "426 W 1ST ST",
            "city": "CASPER",
            "state": "WY",
            "postal_code": "826012408",
            "telephone_number": "307-266-6908",
            "fax_number": "307-266-2583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "426 W 1ST ST",
            "city": "CASPER",
            "state": "WY",
            "postal_code": "826012408",
            "telephone_number": "307-266-6908",
            "fax_number": "307-266-2583"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIDHAM LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-05",
        "last_updated": "2018-07-05",
        "status": "A",
        "authorized_official_last_name": "PRIDHAM",
        "authorized_official_first_name": "NINA",
        "authorized_official_title_or_position": "OWNER/DOCTOR",
        "authorized_official_telephone_number": "503-703-6120",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WY",
            "license": "772",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Healthsource of Casper",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Chiropractor in Casper, WY
• Providers in Casper, WY by specialty
• Chiropractor in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2018; 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.