NPIMap

Organization Active NPI

Middendorf Chiropractic PS

  • Chiropractor
  • Port Orchard, WA
National Provider Identifier
1134514656
Registry record updated Apr 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
MIDDENDORF CHIROPRACTIC PS
Practice address
4255 SE Mile Hill Dr
# 101
Port Orchard, WA 98366-3920
Phone
(360) 871-5200
Fax
(360) 871-5350
NPI assigned
Apr 1, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2015

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

Authorized official

Name
Mrs. Rebekah Rose Lewis
Title
Office Manager
Phone
(360) 871-5200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

4255 SE Mile Hill Dr
# 101
Port Orchard, WA 98366-3920

Mailing address

PO Box 525
Port Orchard, WA 98366-0525
Phone (360) 871-5200

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20151030002211 WA Part B Supplier - Clinic/Group Practice 8527378793 Receives reassigned benefits from 1 practitioner
Practice locations: Port Orchard, WA

National Provider Directory

National Provider Directory

Locations

4255 SE Mile Hill Dr
Ste 101
Port Orchard, WA 98366
Phone (360) 871-5200

2021 SE Sedgwick Rd
Ste 1
Port Orchard, WA 98366
Phone (360) 265-2584

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": "1427846400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427846400000",
    "number": "1134514656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 525",
            "city": "PORT ORCHARD",
            "state": "WA",
            "postal_code": "983660525",
            "telephone_number": "360-871-5200",
            "fax_number": "360-817-5350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4255 SE MILE HILL DR",
            "address_2": "# 101",
            "city": "PORT ORCHARD",
            "state": "WA",
            "postal_code": "983663920",
            "telephone_number": "360-871-5200",
            "fax_number": "360-871-5350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDDENDORF CHIROPRACTIC PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-01",
        "last_updated": "2015-04-01",
        "status": "A",
        "authorized_official_last_name": "LEWIS",
        "authorized_official_first_name": "REBEKAH",
        "authorized_official_middle_name": "ROSE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "360-871-5200",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Orchard, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2015; 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.