Active NPI
John Bruce Permen, D.C.
- Chiropractor
- Lynden, WA
National Provider Identifier
1003917329
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 001920
- Practice address
- 260 Bay Lyn Dr
Lynden, WA 98264-9464 - Phone
- (360) 354-6800
- NPI assigned
- Sep 26, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 001920 | WA | Primary |
Addresses
Primary practice location
260 Bay Lyn Dr
Lynden, WA 98264-9464
Mailing address
260 Bay Lyn Dr
Lynden, WA 98264-9405
Phone (360) 354-6800
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6020 | Other | WA | DEPT. OF LABOR & INDUST |
| 653559 | Other | WA | ACN |
| G8806685 | Other | WA | MEDICARE ID-TYPE UNSPECIFIED |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Other, 1976
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
1610 Grover St
Lynden, WA 98264-1539
Phone (360) 354-6800
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 001920 | WA | MD | Chiropractor |
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.
-
- Chiropractor
- Lynden, WA
- NPI 1548485105
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159228800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1474848000000",
"number": "1003917329",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "260 BAY LYN DR",
"city": "LYNDEN",
"state": "WA",
"postal_code": "982649405",
"telephone_number": "360-354-6800"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "260 BAY LYN DR",
"city": "LYNDEN",
"state": "WA",
"postal_code": "982649464",
"telephone_number": "360-354-6800"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PERMEN",
"first_name": "JOHN",
"middle_name": "BRUCE",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-26",
"last_updated": "2016-09-26",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "WA",
"license": "001920",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DEPT. OF LABOR & INDUST",
"identifier": "6020",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ACN",
"identifier": "653559",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE ID-TYPE UNSPECIFIED",
"identifier": "G8806685",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lynden, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2016; 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.