Individual provider Active NPI

James E. Fitzpatrick, D.C., PS.

  • Chiropractor
  • Issaquah, WA
National Provider Identifier
1013937754
Registry record updated Jan 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH000000801 Issued in WA
Practice address
465 Rainier Blvd N
Issaquah, WA 98027-2826
Phone
(425) 392-5321
Fax
(425) 837-3785
NPI assigned
Jul 19, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 10, 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 CH000000801 WA Primary

Addresses

Primary practice location

465 Rainier Blvd N
Issaquah, WA 98027-2826

Mailing address

465 Rainier Blvd N
Ste a
Issaquah, WA 98027-2826
Phone (425) 392-5321

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040206000611 WA Practitioner - Chiropractic 4284527722

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH000000801WAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
James E. Fitzpatrick, D.C. PS Chiropractor CurrentSince Oct 30, 2012 Accepting new patients
Absolute Wellness Clinic, P.S. Past Accepting new patients

Locations

465 Rainier Blvd N
Issaquah, WA 98027
Phone (425) 392-5321

465 Rainier Blvd N
Ste A
Issaquah, WA 98027
Phone (425) 392-5321

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": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1515542400000",
    "number": "1013937754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "465 RAINIER BLVD N",
            "address_2": "STE A",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980272826",
            "telephone_number": "425-392-5321",
            "fax_number": "425-392-5321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "465 RAINIER BLVD N",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980272826",
            "telephone_number": "425-392-5321",
            "fax_number": "425-837-3785"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FITZPATRICK",
        "first_name": "JAMES",
        "middle_name": "E.",
        "name_prefix": "Dr.",
        "credential": "D.C.,  PS.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2018-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH000000801",
            "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 Jan 10, 2018; 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.

Verify at the official NPI Registry.