NPIMap

Organization Active NPI

Bremerton Wellness PS

  • Chiropractor
  • Bremerton, WA
National Provider Identifier
1073032157
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH00034574 Issued in WA
Legal business name
BREMERTON WELLNESS PS
Practice address
5050 Hwy 303 NE
Suite a 101
Bremerton, WA 98311
Phone
(360) 627-7408
NPI assigned
Sep 11, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Sahibjit Gill, DCNPI 1124105598
Title
Owner
Phone
(360) 627-7408

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X CH00034574 WA Primary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X CH60306466 WA
AcupuncturistGroup: 193200000X MULTI-SPECIALTY GROUP 171100000X AC60735057 WA

Addresses

Primary practice location

5050 Hwy 303 NE
Suite a 101
Bremerton, WA 98311

Mailing address

5050 Wa State Highway 303
Site 101
Bremerton, WA 98311
Phone (360) 627-7408

Other identifiers 1

IdentifierTypeStateIssuer
1952653354MedicaidWA

Other names 1

  • Bremerton Wellness Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070712000325 WA Part B Supplier - Clinic/Group Practice 8325148869 Receives reassigned benefits from 4 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Kingston, WA; Bremerton, WA

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

5050 State Highway 303 NE
#101
Bremerton, WA 98311

Practitioners & affiliated clinicians

Practitioners 4

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": "1505088000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1073032157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5050 WA STATE HIGHWAY 303",
            "address_2": "SITE 101",
            "city": "BREMERTON",
            "state": "WA",
            "postal_code": "98311",
            "telephone_number": "360-627-7408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5050 HWY 303 NE",
            "address_2": "SUITE A 101",
            "city": "BREMERTON",
            "state": "WA",
            "postal_code": "98311",
            "telephone_number": "360-627-7408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BREMERTON WELLNESS PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-11",
        "last_updated": "2022-07-21",
        "certification_date": "2021-09-01",
        "status": "A",
        "authorized_official_last_name": "GILL",
        "authorized_official_first_name": "SAHIBJIT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "360-627-7408",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH00034574",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH60306466",
            "primary": false
        },
        {
            "code": "171100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Acupuncturist",
            "state": "WA",
            "license": "AC60735057",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1952653354",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bremerton Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bremerton, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.