Individual provider Active NPI

Steven Edward Kosmider, DC

  • Chiropractor
  • Lacey, WA
National Provider Identifier
1043359607
Registry record updated Sep 17, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH00002159 Issued in WA
Practice address
1401 Marvin Rd NE
#107
Lacey, WA 98516-5709
Phone
(360) 459-5990
Fax
(360) 456-0222
NPI assigned
Feb 6, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 17, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH00002159 WA Primary

Addresses

Primary practice location

1401 Marvin Rd NE
#107
Lacey, WA 98516-5709

Mailing address

1401 Marvin Rd NE
#107
Lacey, WA 98516-5709
Phone (360) 459-5990

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120104000587 WA Practitioner - Chiropractic 3476729930 Practice locations: Olympia, WA

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - West Sunnyvale, 1985
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

7267 Martin Way E
Olympia, WA 98516-5534
Phone (360) 459-5990

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH00002159WAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Living Oap, PLLC Chiropractor Past Accepting new patients
Chiropractic Sports & Family Health Center, P.S. Chiropractor Past Accepting new patients

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": "1170720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1284681600000",
    "number": "1043359607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 MARVIN RD NE",
            "address_2": "#107",
            "city": "LACEY",
            "state": "WA",
            "postal_code": "985165709",
            "telephone_number": "360-459-5990",
            "fax_number": "360-456-0222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 MARVIN RD NE",
            "address_2": "#107",
            "city": "LACEY",
            "state": "WA",
            "postal_code": "985165709",
            "telephone_number": "360-459-5990",
            "fax_number": "360-456-0222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOSMIDER",
        "first_name": "STEVEN",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-06",
        "last_updated": "2010-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH00002159",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lacey, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2010; 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.