HICKORY HEALTH CLINIC PLLC
NPI 1043841414
Chiropractor in Forest Lake, MN
About Hickory Health Clinic Pllc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
HICKORY HEALTH CLINIC PLLC (NPI 1043841414) is a healthcare organization registered as a chiropractor in Forest Lake, Minnesota and active in the NPI registry since February 2020. The organization lists Richard Vincent Ottomeyer, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 1
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Hickory Health Clinic Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Hickory Health Clinic PLLC, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Hickory Health Clinic PLLC's NPI number?
The NPI number for Hickory Health Clinic PLLC is 1043841414. It was assigned to this organization in the NPPES registry on February 3, 2020.
Where is Hickory Health Clinic PLLC located?
Hickory Health Clinic PLLC is located at 168 Lake St S Ste C, Forest Lake, MN 55025. The listed phone number is (651) 226-8338.
What is Hickory Health Clinic PLLC's specialty?
The primary specialty registered for this NPI is Chiropractor with taxonomy code 111N00000X.
Is Hickory Health Clinic PLLC enrolled in Medicare?
Yes. Hickory Health Clinic PLLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Hickory Health Clinic PLLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Chiropractic) reassigns their Medicare billing to Hickory Health Clinic PLLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
What insurance does Hickory Health Clinic PLLC accept?
Health plans from HealthPartners list Hickory Health Clinic PLLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Hickory Health Clinic PLLC was last updated on February 17, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Hickory Health Clinic Pllc · NPI 1043841414
Chiropractor organization in Forest Lake, Minnesota. Organization record, active in the CMS NPPES registry since February 3, 2020.
## Identity
- **NPI:** 1043841414 (Entity type: Organization)
- **Enumerated:** February 3, 2020
- **Primary specialty:** Chiropractor · taxonomy 111N00000X
- **Organization subpart:** No
- **Authorized official:** Richard Ottomeyer, OWNER
## Practice location
- **Address:** 168 LAKE ST S STE C, Forest Lake, MN 55025-4401
- **Phone:** (651) 226-8338
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Chiropractic) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** February 17, 2020
- **Other identifiers:** Medicaid 51352700 (MN)
---
Source: [NPI Profile](https://npiprofile.com/npi/1043841414) · Data from the CMS NPPES public registry.