NPIMap

Organization Active NPI

Progressive Wellness Center,PLLC

  • Chiropractor
  • Everett, WA
National Provider Identifier
1114054079
Registry record updated Dec 5, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH00033910 Issued in WA
Legal business name
PROGRESSIVE WELLNESS CENTER,PLLC
Practice address
711 112TH St SE
Suite C
Everett, WA 98208-5283
Phone
(206) 992-2561
NPI assigned
Feb 27, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2007

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

Authorized official

Name
Dr. Ronnie Sikka, DCNPI 1700913662
Title
Owner
Phone
(206) 992-2561

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X CH00033910 WA Primary

Addresses

Primary practice location

711 112TH St SE
Suite C
Everett, WA 98208-5283

Mailing address

711 112TH St SE
Suite C
Everett, WA 98208-5283
Phone (206) 992-2561

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071207000259 WA Part B Supplier - Clinic/Group Practice 6103915616 Receives reassigned benefits from 1 practitioner
Practice locations: Everett, WA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196812800000",
    "number": "1114054079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 112TH ST SE",
            "address_2": "SUITE C",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982085283",
            "telephone_number": "206-992-2561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 112TH ST SE",
            "address_2": "SUITE C",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982085283",
            "telephone_number": "206-992-2561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROGRESSIVE WELLNESS CENTER,PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-27",
        "last_updated": "2007-12-05",
        "status": "A",
        "authorized_official_last_name": "SIKKA",
        "authorized_official_first_name": "RONNIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "206-992-2561",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH00033910",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Everett, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2007; 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.