Individual provider Active NPI

Ronald Allen McCorkle, DC

  • Chiropractor
  • Bonney Lake, WA
National Provider Identifier
1093894677
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH00001508 Issued in WA
Practice address
18310 Hwy 410 East
Bonney Lake, WA 98391
Phone
(253) 863-6377
Fax
(253) 863-2052
NPI assigned
Nov 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH00001508 WA Primary

Addresses

Primary practice location

18310 Hwy 410 East
Bonney Lake, WA 98391

Mailing address

18310 Hwy 410 East
Bonney Lake, WA 98391
Phone (253) 863-6377

Other identifiers 1

IdentifierTypeStateIssuer
16925OtherWALABOR & INDUSTRIES

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

NPI Registry JSON

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

{
    "created_epoch": "1162512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1093894677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18310 HWY 410 EAST",
            "city": "BONNEY LAKE",
            "state": "WA",
            "postal_code": "98391",
            "telephone_number": "253-863-6377",
            "fax_number": "253-863-2052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18310 HWY 410 EAST",
            "city": "BONNEY LAKE",
            "state": "WA",
            "postal_code": "98391",
            "telephone_number": "253-863-6377",
            "fax_number": "253-863-2052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCORKLE",
        "first_name": "RONALD",
        "middle_name": "ALLEN",
        "name_prefix": "Mr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH00001508",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR & INDUSTRIES",
            "identifier": "16925",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bonney Lake, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.