Individual provider Active NPI

Carl Randolph Baze, D.C.

  • Chiropractor
  • Renton, WA
National Provider Identifier
1003959453
Registry record updated Aug 24, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH00001895 Issued in WA
Practice address
200 SW 41St St
Suite 100
Renton, WA 98057
Phone
(425) 251-5715
Fax
(425) 251-0703
NPI assigned
Feb 15, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 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 CH00001895 WA Primary

Addresses

Primary practice location

200 SW 41St St
Suite 100
Renton, WA 98057

Mailing address

200 SW 41St St
Suite 100
Renton, WA 98057
Phone (425) 251-5715

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080522000490 WA Practitioner - Chiropractic 0648349258 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Sherman College of Straight Chiropractic, 1983
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

200 SW 41St St
Suite 100
Renton, WA 98057-4931
Phone (425) 251-5715

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Baze Chiropractic, PLLC Chiropractor CurrentSince Aug 25, 2015 Accepting new patients

Locations

200 SW 41st St
Ste 100
Renton, WA 98057
Phone (425) 251-5715

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": "1171497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282608000000",
    "number": "1003959453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 SW 41ST ST",
            "address_2": "SUITE 100",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "98057",
            "telephone_number": "425-251-5715",
            "fax_number": "425-251-0703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 SW 41ST ST",
            "address_2": "SUITE 100",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "98057",
            "telephone_number": "425-251-5715",
            "fax_number": "425-251-0703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAZE",
        "first_name": "CARL",
        "middle_name": "RANDOLPH",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-15",
        "last_updated": "2010-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH00001895",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Renton, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2010; 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.