NPIMap

Organization Active NPI

Kelley Chiropractic Wellness Center PLLC

  • Chiropractor
  • Kirkland, WA
National Provider Identifier
1063634855
Registry record updated Oct 18, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH00003676 Issued in WA
Legal business name
KELLEY CHIROPRACTIC WELLNESS CENTER PLLC
Practice address
12305 120TH Ave NE
Suite a
Kirkland, WA 98034-6921
Phone
(425) 820-2777
Fax
(425) 821-5528
NPI assigned
May 3, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2007

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

Authorized official

Name
Dr. Joseph R Kelley, DCNPI 1689781528
Title
Managing Member
Phone
(425) 820-2777

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X CH00003676 WA Primary

Addresses

Primary practice location

12305 120TH Ave NE
Suite a
Kirkland, WA 98034-6921

Mailing address

12305 120TH Ave NE
Suite a
Kirkland, WA 98034-6921
Phone (425) 820-2777

Other identifiers 2

IdentifierTypeStateIssuer
KE7942OtherWAREGENCE RYDER NUMBER
129284OtherWALABOR & INDUSTRIES

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192665600000",
    "number": "1063634855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12305 120TH AVE NE",
            "address_2": "SUITE A",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980346921",
            "telephone_number": "425-820-2777",
            "fax_number": "425-821-5528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12305 120TH AVE NE",
            "address_2": "SUITE A",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980346921",
            "telephone_number": "425-820-2777",
            "fax_number": "425-821-5528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KELLEY CHIROPRACTIC WELLNESS CENTER PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-03",
        "last_updated": "2007-10-18",
        "status": "A",
        "authorized_official_last_name": "KELLEY",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "425-820-2777",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH00003676",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE RYDER NUMBER",
            "identifier": "KE7942",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR & INDUSTRIES",
            "identifier": "129284",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kirkland, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2007; 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.