NPIMap

Organization Active NPI

Battle Ground Advantage Chiropractic PS

Doing business as Advantage Chiropractic

  • Chiropractor
  • Battle Ground, WA
National Provider Identifier
1104507425
Registry record updated Aug 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
BATTLE GROUND ADVANTAGE CHIROPRACTIC PS
Doing business as
Advantage Chiropractic
Practice address
2210 W Main St Ste 101
Battle Ground, WA 98604-4232
Phone
(360) 369-5150
NPI assigned
Jul 28, 2023
Last updated
Aug 13, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2024

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

Authorized official

Name
Skylar Clark
Title
Manager
Phone
(360) 369-5150

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X NU Primary

Addresses

Primary practice location

2210 W Main St Ste 101
Battle Ground, WA 98604-4232

Mailing address

1312 Vandercook Way
Longview, WA 98632-3902
Phone (360) 425-6620

Other names 1

  • Advantage Chiropractic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240719001392 WA Part B Supplier - Clinic/Group Practice 1658817200 Receives reassigned benefits from 1 practitioner
Practice locations: Battle Ground, WA

National Provider Directory

National Provider Directory

Locations

2210 W Main St
Ste 101
Battle Ground, WA 98604
Phone (360) 369-5150

Practitioners & affiliated clinicians

Practitioners 15

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.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1690502400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723507200000",
    "number": "1104507425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1312 VANDERCOOK WAY",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986323902",
            "telephone_number": "360-425-6620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2210 W MAIN ST STE 101",
            "city": "BATTLE GROUND",
            "state": "WA",
            "postal_code": "986044232",
            "telephone_number": "360-369-5150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BATTLE GROUND ADVANTAGE CHIROPRACTIC PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-28",
        "last_updated": "2024-08-13",
        "certification_date": "2024-08-13",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "SKYLAR",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "360-369-5150"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advantage Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Advantage Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Battle Ground, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2024; 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.