Individual provider Active NPI

Eric Drazich, D.C.

  • Chiropractor
  • Gold Bar, WA
National Provider Identifier
1013289289
Registry record updated May 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH60834604 Issued in WA
Practice address
301 Croft Ave
Gold Bar, WA 98251
Phone
(360) 793-0904
Fax
(360) 799-0923
NPI assigned
Feb 3, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH60834604 WA Primary

Addresses

Primary practice location

301 Croft Ave
Gold Bar, WA 98251

Mailing address

301 Croft Ave
Gold Bar, WA 98251
Phone (360) 793-0904

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180522000554 WA Practitioner - Chiropractic 3577723774 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gold Bar Chiropractic P LLCGroup PAC ID 4486714086, 2 clinicians

Practice addresses (Care Compare)

301 Croft Ave W
Gold Bar, WA 98251-9482
Phone (360) 793-0904

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
32084CAMDPsychologist
CH60834604WAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Gold Bar Chiropractic P.L.L.C Chiropractor CurrentSince May 7, 2018 Accepting new patients
Mt. Shasta Physical Therapy, Inc. PastSince Oct 1, 2010 Accepting new patients

Locations

301 Croft Ave
Gold Bar, WA 98251
Phone (360) 793-0904

Networks

  • WA PPO C-SNP
  • devoted network organization-83621310-88c0-4660-8f8d-b8ea8f4dc04e

Organizations & group practices 2

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": "1328227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525651200000",
    "number": "1013289289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 CROFT AVE",
            "city": "GOLD BAR",
            "state": "WA",
            "postal_code": "98251",
            "telephone_number": "360-793-0904",
            "fax_number": "360-799-0923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 CROFT AVE",
            "city": "GOLD BAR",
            "state": "WA",
            "postal_code": "98251",
            "telephone_number": "360-793-0904",
            "fax_number": "360-799-0923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRAZICH",
        "first_name": "ERIC",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-02-03",
        "last_updated": "2018-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH60834604",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gold Bar, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2018; 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.