Individual provider Active NPI

Nicole Leshaw, D.C.

  • Chiropractor
  • Issaquah, WA
National Provider Identifier
1013308196
Registry record updated Sep 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH60534610 Issued in WA
Practice address
1151 NW Sammamish Rd
#101
Issaquah, WA 98027
Phone
(425) 369-1040
NPI assigned
Feb 11, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH60534610 WA Primary

Addresses

Primary practice location

1151 NW Sammamish Rd
#101
Issaquah, WA 98027

Mailing address

17651 1St Ave S
Ste 101
Normandy Park, WA 98148-2715
Phone (425) 369-1040

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150716001496 WA Practitioner - Chiropractic 7113230376 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

17651 1St Ave S
Suite 101
Normandy Park, WA 98148-2715
Phone (206) 241-3836

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH60534610WAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Leshaw Chiropractic PLLC CurrentSince Jul 6, 2018 Accepting new patients
Daryll G. Marshall-Inman DC Inc. Chiropractor CurrentSince Sep 1, 2019 Accepting new patients

Locations

17651 1st Ave S
Ste 101
Normandy Park, WA 98148
Phone (206) 241-3826

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": "1423612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568592000000",
    "number": "1013308196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17651 1ST AVE S",
            "address_2": "STE 101",
            "city": "NORMANDY PARK",
            "state": "WA",
            "postal_code": "981482715",
            "telephone_number": "425-369-1040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1151 NW SAMMAMISH RD",
            "address_2": "#101",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "98027",
            "telephone_number": "425-369-1040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LESHAW",
        "first_name": "NICOLE",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-11",
        "last_updated": "2019-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH60534610",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Issaquah, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2019; 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.