Active NPI
Kevin Michael Earle, DC, CCEP
- Chiropractor
- Puyallup, WA
National Provider Identifier
1013050152
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- CH00034075
- Practice address
- 10202 149TH St E
Suite 101B
Puyallup, WA 98374-3746 - Phone
- (253) 445-0440
- Fax
- (253) 445-0444
- NPI assigned
- Feb 15, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 | CH00034075 | WA | Primary |
Addresses
Primary practice location
10202 149TH St E
Suite 101B
Puyallup, WA 98374-3746
Mailing address
13613 Meridian E Ste 260
Puyallup, WA 98373-9800
Phone (253) 445-0440
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120424000057 | WA | Practitioner - Chiropractic | 1951563758 | Practice locations: Puyallup, WA |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rainier Sports and Spinal Rehab, Inc | Chiropractor | Past | Accepting new patients |
Networks
- WA PPO C-SNP
- devoted network organization-83621310-88c0-4660-8f8d-b8ea8f4dc04e
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
- Puyallup, WA
- NPI 1841548625
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": "1492646400000",
"number": "1013050152",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13613 MERIDIAN E STE 260",
"city": "PUYALLUP",
"state": "WA",
"postal_code": "983739800",
"telephone_number": "253-445-0440",
"fax_number": "253-445-0444"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10202 149TH ST E",
"address_2": "SUITE 101B",
"city": "PUYALLUP",
"state": "WA",
"postal_code": "983743746",
"telephone_number": "253-445-0440",
"fax_number": "253-445-0444"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EARLE",
"first_name": "KEVIN",
"middle_name": "MICHAEL",
"name_prefix": "Dr.",
"credential": "DC, CCEP",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-02-15",
"last_updated": "2017-04-20",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "WA",
"license": "CH00034075",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Puyallup, WA
- Ear Nose Throat & Plastic Surgery Associates of the South Sound PS
- Ear, Nose, Throat & Allergy Assoicaties PS
- Ear,Nose,Throat & Allergy Associates PS
- Ear,Nose,Throat &Allergy Associates PS
- Stacy Marie Earl, COTA/L
- Timothy P Earnest, M.D.
- Morgan Taylor Easley, LMT
- East Main Vision Clinic LLC
- Joel Aldor Eastman, RPH
- Blair A Eather
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2017; 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.