Individual provider Active NPI

Melody C. Libatique, DC

  • Chiropractor
  • Bellevue, WA
National Provider Identifier
1043601719
Registry record updated Feb 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH60533383 Issued in WA
Practice address
1370 116TH Ave NE
Bellevue, WA 98004-3825
Phone
(424) 454-0199
Fax
(425) 462-1742
NPI assigned
Feb 16, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 16, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH60533383 WA Primary

Addresses

Primary practice location

1370 116TH Ave NE
Bellevue, WA 98004-3825

Mailing address

2639 S 310TH St
Federal Way, WA 98003-5009
Phone (971) 258-8576

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH60533383WAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Auto Injury Pain Clinic Chiropractor Current Accepting new patients

Organizations & group practices 1

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": "1424044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424044800000",
    "number": "1043601719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2639 S 310TH ST",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980035009",
            "telephone_number": "971-258-8576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1370 116TH AVE NE",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980043825",
            "telephone_number": "424-454-0199",
            "fax_number": "425-462-1742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIBATIQUE",
        "first_name": "MELODY",
        "middle_name": "C.",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-02-16",
        "last_updated": "2015-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH60533383",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.