Individual provider Active NPI

Keith L Hediger, D.C.

  • Chiropractor
  • Homer, AK
National Provider Identifier
1962409631
Registry record updated Jan 19, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
124 Issued in AK
Practice address
3858 Lake St
Ste. 20
Homer, AK 99603-7682
Phone
(907) 235-7221
Fax
(907) 235-3430
NPI assigned
Jul 7, 2005
Last updated
Jan 19, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 19, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 124 AK Primary

Addresses

Primary practice location

3858 Lake St
Ste. 20
Homer, AK 99603-7682

Mailing address

3858 Lake St
Ste. 20
Homer, AK 99603-7682
Phone (907) 235-7221

Other identifiers 1

IdentifierTypeStateIssuer
CH0124MedicaidAK

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

Practice roles

OrganizationSpecialtyStatusNew patients
Arctic Chiropractic Homer Chiropractor PastSince Jun 22, 2021 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": "1120694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1263859200000",
    "number": "1962409631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3858 LAKE ST",
            "address_2": "STE. 20",
            "city": "HOMER",
            "state": "AK",
            "postal_code": "996037682",
            "telephone_number": "907-235-7221",
            "fax_number": "907-235-3430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3858 LAKE ST",
            "address_2": "STE. 20",
            "city": "HOMER",
            "state": "AK",
            "postal_code": "996037682",
            "telephone_number": "907-235-7221",
            "fax_number": "907-235-3430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEDIGER",
        "first_name": "KEITH",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-07",
        "last_updated": "2010-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AK",
            "license": "124",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "CH0124",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Homer, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2010; 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.