NPIMap

Organization Active NPI

Greenlee Wellness Center PS

  • Chiropractor
  • Olympia, WA
National Provider Identifier
1134326499
Registry record updated Jun 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH00034163 Issued in WA
Legal business name
GREENLEE WELLNESS CENTER PS
Practice address
1824 Black Lake Blvd SW Ste C
Olympia, WA 98512-5718
Phone
(360) 705-0900
Fax
(360) 754-6151
NPI assigned
Jun 29, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2008

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

Authorized official

Name
Dr. Daniel F. Greenlee, D.C.NPI 1285778043
Title
Clinic Director
Phone
(360) 705-0900

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: 193400000X SINGLE SPECIALTY GROUP 111N00000X CH00034163 WA Primary

Addresses

Primary practice location

1824 Black Lake Blvd SW Ste C
Olympia, WA 98512-5718

Mailing address

1824 Black Lake Blvd SW Ste C
Olympia, WA 98512-5718
Phone (360) 705-0900

Other names 1

  • Pinnacle Spine & Disc Rehabilitation Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040508000384 WA Part B Supplier - Clinic/Group Practice 0547259293 Receives reassigned benefits from 1 practitioner
Practice locations: Olympia, WA

National Provider Directory

National Provider Directory

Locations

1824 Black Lake Blvd SW
Ste C
Olympia, WA 98512
Phone (360) 705-0900

Practitioners & affiliated clinicians

Practitioners 3

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": "1183075200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212710400000",
    "number": "1134326499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1824 BLACK LAKE BLVD SW STE C",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985125718",
            "telephone_number": "360-705-0900",
            "fax_number": "360-754-6151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1824 BLACK LAKE BLVD SW STE C",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985125718",
            "telephone_number": "360-705-0900",
            "fax_number": "360-754-6151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREENLEE WELLNESS CENTER PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-29",
        "last_updated": "2008-06-06",
        "status": "A",
        "authorized_official_last_name": "GREENLEE",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "F.",
        "authorized_official_title_or_position": "CLINIC DIRECTOR",
        "authorized_official_telephone_number": "360-705-0900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH00034163",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pinnacle Spine & Disc Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Olympia, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2008; 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.