Alta Dawne Mahan, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CH00033625 Issued in WA

Practice address

20119 S Prairie Rd E
Bonney Lake, WA 98391-7935

Phone

(253) 862-1555

Fax

(253) 862-1557

NPI assigned

Jul 24, 2006

Last updated

Sep 20, 2013By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Alta Dawne Antypowich Former name

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Specialty

Chiropractic

Education

Palmer College Chiropractic - Davenport, 1999

Medicare assignment

May accept Medicare assignment

Group practices

Henschell Chiropractic, P.S.Group PAC ID 5193786051, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Henschell Chiropractic, P.S.

  • Chiropractor
  • Bonney Lake, WA
  • NPI 1255354296
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379635200000",
    "number": "1144242389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20119 S PRAIRIE RD E",
            "city": "BONNEY LAKE",
            "state": "WA",
            "postal_code": "983917935",
            "telephone_number": "253-862-1555",
            "fax_number": "253-862-1557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20119 S PRAIRIE RD E",
            "city": "BONNEY LAKE",
            "state": "WA",
            "postal_code": "983917935",
            "telephone_number": "253-862-1555",
            "fax_number": "253-862-1557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHAN",
        "first_name": "ALTA",
        "middle_name": "DAWNE",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-24",
        "last_updated": "2013-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH00033625",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALTA",
            "last_name": "ANTYPOWICH",
            "middle_name": "DAWNE",
            "credential": "D.C.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Chiropractor in Bonney Lake, WA
• Providers in Bonney Lake, WA by specialty
• Chiropractor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2013; 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.