Individual provider Active NPI

Keane Joseph Bagby, D.C.

  • Chiropractor
  • Federal Way, WA
National Provider Identifier
1093893489
Registry record updated Mar 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH000001865 Issued in WA
Practice address
30804 Pacific Hwy S
Federal Way, WA 98003-4902
Phone
(425) 251-9770
Fax
(425) 251-9846
NPI assigned
Nov 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH000001865 WA Primary

Addresses

Primary practice location

30804 Pacific Hwy S
Federal Way, WA 98003-4902

Mailing address

27177 185TH Ave SE Ste 111-231
Covington, WA 98042-8455
Phone (425) 251-9770

Other identifiers 2

IdentifierTypeStateIssuer
BA3849OtherWAREGENCE
24854OtherWALABOR & INDUSTRIES

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051026000484 WA Practitioner - Chiropractic 2769409044 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College - West, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

435 SW 41St St
Renton, WA 98057-4926
Phone (425) 251-9770

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH000001865WAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Bagby Chiropractic PLLC Chiropractor CurrentSince Oct 14, 2014 Accepting new patients

Locations

435 SW 41st St
Renton, WA 98057
Phone (206) 251-9770

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773014400000",
    "number": "1093893489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27177 185TH AVE SE STE 111-231",
            "city": "COVINGTON",
            "state": "WA",
            "postal_code": "980428455",
            "telephone_number": "425-251-9770",
            "fax_number": "425-251-9846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30804 PACIFIC HWY S",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980034902",
            "telephone_number": "425-251-9770",
            "fax_number": "425-251-9846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAGBY",
        "first_name": "KEANE",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2026-03-09",
        "certification_date": "2026-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH000001865",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE",
            "identifier": "BA3849",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR & INDUSTRIES",
            "identifier": "24854",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Federal Way, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.