Individual provider Active NPI

Michael W Fisk, D.C.

  • Chiropractor
  • Spokane Valley, WA
National Provider Identifier
1093803272
Registry record updated Feb 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH00001692 Issued in WA
Practice address
1124 S Pines Rd
Spokane Valley, WA 99206-5427
Phone
(509) 922-1909
Fax
(509) 922-6648
NPI assigned
Oct 11, 2006
Last updated
Feb 4, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH00001692 WA Primary

Addresses

Primary practice location

1124 S Pines Rd
Spokane Valley, WA 99206-5427

Mailing address

1124 S Pines Rd
Spokane Valley, WA 99206-5427
Phone (509) 922-1909

Other identifiers 2

IdentifierTypeStateIssuer
58694OtherWALABOR & INDUSTRIES
C992-5OtherWAPREMERA BLUE CROSS

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
CH00001692WAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Asdrubal I Lopez, DC, PS Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202083200000",
    "number": "1093803272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1124 S PINES RD",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "992065427",
            "telephone_number": "509-922-1909",
            "fax_number": "509-922-6648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1124 S PINES RD",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "992065427",
            "telephone_number": "509-922-1909",
            "fax_number": "509-922-6648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISK",
        "first_name": "MICHAEL",
        "middle_name": "W",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-11",
        "last_updated": "2008-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH00001692",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR & INDUSTRIES",
            "identifier": "58694",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREMERA BLUE CROSS",
            "identifier": "C992-5",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane Valley, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2008; 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.