Individual provider Active NPI

Tiffany Ann Hicken, D.C.

  • Chiropractor
  • Grand Island, NE
National Provider Identifier
1962597955
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1134 Issued in NE
Practice address
706 W 4TH St
Grand Island, NE 68801-4529
Phone
(308) 382-7470
Fax
(308) 382-9398
NPI assigned
Oct 4, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1134 NE Primary

Addresses

Primary practice location

706 W 4TH St
Grand Island, NE 68801-4529

Mailing address

706 W 4TH St
Grand Island, NE 68801-4529
Phone (308) 389-4909

Other identifiers 1

IdentifierTypeStateIssuer
47076250613MedicaidNE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110224000812 NE Practitioner - Chiropractic 6901087865 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1134NEMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Hicken Chiropractic, P.C. Chiropractor CurrentSince Jun 29, 2011 Accepting new patients

Locations

512 10th St
Gothenburg, NE 69138
Phone (308) 537-5500

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1962597955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "706 W 4TH ST",
            "city": "GRAND ISLAND",
            "state": "NE",
            "postal_code": "688014529",
            "telephone_number": "308-389-4909",
            "fax_number": "308-382-9398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "706 W 4TH ST",
            "city": "GRAND ISLAND",
            "state": "NE",
            "postal_code": "688014529",
            "telephone_number": "308-382-7470",
            "fax_number": "308-382-9398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HICKEN",
        "first_name": "TIFFANY",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NE",
            "license": "1134",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47076250613",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Island, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.