Brian Christopher Wickstrom, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CHIR.CH.60139083 Issued in WA

Practice address

615 N Sullivan Rd
Spokane Valley, WA 99037-8574

Phone

(509) 342-9438

NPI assigned

Apr 19, 2010

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Specialty

Chiropractic

Education

Palmer College Chiropractic - Davenport, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• River City Chiropractic LLC

  • Chiropractor
  • Spokane Valley, WA
  • NPI 1164701744
  Medicare reassignment Authorized official
• River City Chiropractic

  • Chiropractor
  • Spokane Valley, WA
  • NPI 1538465000
  NPD (past) Authorized official

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

{
    "created_epoch": "1271635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1296518400000",
    "number": "1992021737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 N SULLIVAN RD",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "990378574",
            "telephone_number": "509-342-9438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 N SULLIVAN RD",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "990378574",
            "telephone_number": "509-342-9438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WICKSTROM",
        "first_name": "BRIAN",
        "middle_name": "CHRISTOPHER",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-04-19",
        "last_updated": "2011-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CHIR.CH.60139083",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristy Kay Whitney, MSN
• Wholey Healing
• Cassandra Whooley
• Lynea Alexis Wickel
• Savanna Wickering
• Kristin Wickstrom, OTR/L
• Terra Leann Widman, PHARMD
• Luan Sarah Wigen, MASS.MA.70020873
• Kenneth Wilbur
• David James Wilcox, LMP

• Chiropractor in Spokane Valley, WA
• Providers in Spokane Valley, WA by specialty
• Chiropractor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2011; 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.