NPIMap

Organization Active NPI

Ronald Wilcox, DC Inc.

Doing business as Family Chiropractic

  • Chiropractor
  • Tumwater, WA
National Provider Identifier
1083952915
Registry record updated Apr 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
RONALD WILCOX, DC INC.
Doing business as
Family Chiropractic
Practice address
204 Pinehurst Dr SW
Suite 103
Tumwater, WA 98501-4500
Phone
(360) 352-8112
Fax
(360) 352-8113
NPI assigned
Jan 28, 2013
Last updated
Apr 29, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2014

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

Authorized official

Name
Dr. Ronald Dale Wilcox, DCNPI 1023062494
Title
President
Phone
(360) 352-8112

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X Primary
Occupational Health Chiropractor 111NX0100X

Addresses

Primary practice location

204 Pinehurst Dr SW
Suite 103
Tumwater, WA 98501-4500

Mailing address

204 Pinehurst Dr SW
Suite 103
Tumwater, WA 98501-4500
Phone (360) 352-8112

Other identifiers 1

IdentifierTypeStateIssuer
G001002046OtherWAMEDICARE

Other names 1

  • Family Chiropractic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130412000132 WA Part B Supplier - Clinic/Group Practice 5890931067 Receives reassigned benefits from 4 practitioners
Practice locations: Tumwater, WA

National Provider Directory

National Provider Directory

Locations

204 Pinehurst Dr SW
Ste 10
Tumwater, WA 98501

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1359331200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1398729600000",
    "number": "1083952915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 PINEHURST DR SW",
            "address_2": "SUITE 103",
            "city": "TUMWATER",
            "state": "WA",
            "postal_code": "985014500",
            "telephone_number": "360-352-8112",
            "fax_number": "360-352-8113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 PINEHURST DR SW",
            "address_2": "SUITE 103",
            "city": "TUMWATER",
            "state": "WA",
            "postal_code": "985014500",
            "telephone_number": "360-352-8112",
            "fax_number": "360-352-8113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RONALD WILCOX, DC INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-28",
        "last_updated": "2014-04-29",
        "status": "A",
        "authorized_official_last_name": "WILCOX",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "DALE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "360-352-8112",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "111NX0100X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Occupational Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "G001002046",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tumwater, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2014; 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.