Organization Active NPI

Atlas Chiropractic Clinic, LLC

  • Chiropractor
  • Lynnwood, WA
National Provider Identifier
1154532042
Registry record updated Jul 25, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH00034110 Issued in WA
Legal business name
ATLAS CHIROPRACTIC CLINIC, LLC
Practice address
14608 Hwy 99 Suite309
Lynnwood, WA 98087
Phone
(425) 742-0332
Fax
(425) 742-4160
NPI assigned
May 24, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2007

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

Authorized official

Name
Dr. Jinyoung KimNPI 1699864728
Title
Chiropractor
Phone
(425) 742-0332

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 MULTIPLE SINGLE SPECIALTY GROUP 111N00000X CH00034110 WA Primary

Addresses

Primary practice location

14608 Hwy 99 Suite309
Lynnwood, WA 98087

Mailing address

14608 Hwy 99 Suite309
Lynnwood, WA 98037
Phone (425) 742-0332

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070720000151 WA Part B Supplier - Clinic/Group Practice 9335240530 Receives reassigned benefits from 1 practitioner
Practice locations: Lynnwood, WA

National Provider Directory

National Provider Directory

Locations

14608 Highway 99
Ste 309
Lynnwood, WA 98087
Phone (425) 742-0332

Practitioners & affiliated clinicians

Practitioners 2

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": "1179964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1185321600000",
    "number": "1154532042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14608 HWY 99 SUITE309",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "98037",
            "telephone_number": "425-742-0332",
            "fax_number": "425-742-4160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14608 HWY 99 SUITE309",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "98087",
            "telephone_number": "425-742-0332",
            "fax_number": "425-742-4160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATLAS CHIROPRACTIC CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-24",
        "last_updated": "2007-07-25",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "JINYOUNG",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "425-742-0332",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH00034110",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynnwood, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2007; 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.