Mark S Shelley, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CH00001890 Issued in WA

Practice address

6603 220TH St SW
Ste 102
Mountlake Terrace, WA 98043-2186

Phone

(425) 774-2411

Fax

(425) 672-7065

NPI assigned

Nov 1, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Specialty

Chiropractic

Education

Sherman College of Straight Chiropractic, 1983

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Olympic Spine and Sports Therapy PCGroup PAC ID 7416844345, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Olympic Spine and Sports Therapy PC

  • Chiropractor
  • Mountlake Terrace, WA
  • NPI 1629250980
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490140800000",
    "number": "1124105275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6603 220TH ST SW",
            "address_2": "STE 102",
            "city": "MOUNTLAKE TERRACE",
            "state": "WA",
            "postal_code": "980432186",
            "telephone_number": "425-774-2411",
            "fax_number": "425-672-7065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6603 220TH ST SW",
            "address_2": "STE 102",
            "city": "MOUNTLAKE TERRACE",
            "state": "WA",
            "postal_code": "980432186",
            "telephone_number": "425-774-2411",
            "fax_number": "425-672-7065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHELLEY",
        "first_name": "MARK",
        "middle_name": "S",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2017-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH00001890",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2000057",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Laura Lee Shafer
• Crystal Sharpe
• Cynthia G Shaw, LICSW
• Melodie Shdo, LH
• Kyenaat Naz Sheikh
• Kyle Shorack
• Christine Ann Sicuro-Fouty, OTR/L
• Funmilola Omolola Sijuade, PMHNP-BC
• Mark Alan Silver, MD
• Emily Simmonds, DPT

• Chiropractor in Mountlake Terrace, WA
• Providers in Mountlake Terrace, WA by specialty
• Chiropractor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2017; 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.