Individual provider Active NPI

Joeviel Manzanilla, DC

  • Chiropractor
  • Federal Way, WA
National Provider Identifier
1013638980
Registry record updated Sep 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
61350750 Issued in WA
Practice address
1426 S 324TH St Ste B115
Federal Way, WA 98003-8486
Phone
(425) 418-2880
NPI assigned
Sep 8, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 8, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 61350750 WA Primary

Addresses

Primary practice location

1426 S 324TH St Ste B115
Federal Way, WA 98003-8486

Mailing address

1426 S 324TH St Ste B115
Federal Way, WA 98003-8486
Phone (253) 838-1441

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240422002039 WA Practitioner - Chiropractic 7618316746 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tumwater Chiropractic Center P SGroup PAC ID 4385669985, 7 clinicians

Practice addresses (Care Compare)

128 D St SW
Tumwater, WA 98501-4064
Phone (360) 570-9580

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
61350750WAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Pearson Chiropractic PLLC CurrentSince Mar 11, 2024 Accepting new patients
Physical Therapy Empowered, PLLC CurrentSince Jul 9, 2024 Accepting new patients
Tumwater Chiropractic Center PS Chiropractor CurrentSince Jul 9, 2024 Accepting new patients
Back on Track Chiropractic and Massage, LLC Chiropractor PastSince Jun 21, 2022 Accepting new patients

Locations

1426 S 324th St
Ste B115
Federal Way, WA 98003
Phone (253) 638-2424

128 D St SW
Ste A
Tumwater, WA 98501
Phone (360) 570-9580

128 D St SW
Tumwater, WA 98501
Phone (360) 349-8606

Organizations & group practices 4

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": "1662595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662595200000",
    "number": "1013638980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1426 S 324TH ST STE B115",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980038486",
            "telephone_number": "253-838-1441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1426 S 324TH ST STE B115",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980038486",
            "telephone_number": "425-418-2880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANZANILLA",
        "first_name": "JOEVIEL",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-09-08",
        "last_updated": "2022-09-08",
        "certification_date": "2022-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "61350750",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Federal Way, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2022; 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.