NPIMap

Organization Active NPI

Bellevue Chiropractic PS

  • Chiropractor
  • Bellevue, WA
National Provider Identifier
1083711212
Registry record updated Jun 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
601847969 Issued in WA
Legal business name
BELLEVUE CHIROPRACTIC PS
Practice address
1800 116TH Ave. NE Suite 101
Bellevue, WA 98004
Phone
(425) 637-0094
Fax
(425) 453-8298
NPI assigned
Sep 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2025

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

Authorized official

Name
Dr. John A Wisman, D.C.NPI 1073550141
Title
Owner/Chiropractor
Phone
(425) 637-0094

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 601847969 WA Primary

Addresses

Primary practice location

1800 116TH Ave. NE Suite 101
Bellevue, WA 98004

Mailing address

1800 116TH Ave. NE Suite 101
Bellevue, WA 98004
Phone (425) 637-0094

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040331001522 WA Part B Supplier - Clinic/Group Practice 8123010048 Receives reassigned benefits from 5 practitioners
Practice locations: Bellevue, WA

National Provider Directory

National Provider Directory

Locations

320 106th Ave NE
Ste A
Bellevue, WA 98004
Phone (206) 362-1111

Practitioners & affiliated clinicians

Practitioners 11

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": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1749081600000",
    "number": "1083711212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 116TH AVE. NE SUITE 101",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "98004",
            "telephone_number": "425-637-0094",
            "fax_number": "425-453-8298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 116TH AVE. NE SUITE 101",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "98004",
            "telephone_number": "425-637-0094",
            "fax_number": "425-453-8298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BELLEVUE CHIROPRACTIC PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2025-06-05",
        "certification_date": "2025-06-05",
        "status": "A",
        "authorized_official_last_name": "WISMAN",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER/CHIROPRACTOR",
        "authorized_official_telephone_number": "425-637-0094",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "601847969",
            "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 Jun 5, 2025; 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.