Individual provider Active NPI

Jeremy John Welch, D.C.

  • Chiropractor
  • Bellevue, WA
National Provider Identifier
1144398785
Registry record updated Oct 26, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH00034114 Issued in WA
Practice address
15015 Main St
Suite 106
Bellevue, WA 98007-5229
Phone
(425) 643-4454
Fax
(425) 603-0053
NPI assigned
Dec 1, 2006
Last updated
Oct 26, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 26, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH00034114 WA Primary

Addresses

Primary practice location

15015 Main St
Suite 106
Bellevue, WA 98007-5229

Mailing address

15015 Main St
Suite 106
Bellevue, WA 98007-5229
Phone (425) 643-4454

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070131000710 WA Practitioner - Chiropractic 7719989938 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College - West, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

15015 Main St
Suite 106
Bellevue, WA 98007-5229
Phone (425) 643-4454

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Pure Chiropractic 1 PLLC Chiropractor CurrentSince Sep 27, 2006 Accepting new patients
Non Surgical Spine Care Center 1 PLLC Chiropractor PastSince Aug 21, 2011 Accepting new patients
Premier Chiropractic Chiropractor Past Accepting new patients

Locations

15015 Main St
Ste 106
Bellevue, WA 98007
Phone (425) 643-4454

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193356800000",
    "number": "1144398785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15015 MAIN ST",
            "address_2": "SUITE 106",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980075229",
            "telephone_number": "425-643-4454",
            "fax_number": "425-603-0053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15015 MAIN ST",
            "address_2": "SUITE 106",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980075229",
            "telephone_number": "425-643-4454",
            "fax_number": "425-603-0053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELCH",
        "first_name": "JEREMY",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-01",
        "last_updated": "2007-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH00034114",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2007; 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.