Organization Active NPI

Central Wellness Chiropractic PLLC

  • Sports Physician Chiropractor
  • Seattle, WA
National Provider Identifier
1164970778
Registry record updated Sep 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Physician ChiropractorTaxonomy code 111NS0005X
License
CH60239267 Issued in WA
Legal business name
CENTRAL WELLNESS CHIROPRACTIC PLLC
Practice address
1400 20TH Ave
Seattle, WA 98122-2802
Phone
(206) 323-0114
Fax
(844) 329-1722
NPI assigned
Sep 13, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2016

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

Authorized official

Name
Dr. Jeffrey WordNPI 1649550427
Title
Owner/Chiropractor
Phone
(206) 323-0114

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
Sports Physician ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111NS0005X CH60239267 WA Primary

Addresses

Primary practice location

1400 20TH Ave
Seattle, WA 98122-2802

Mailing address

1400 20TH Ave
Seattle, WA 98122-2802
Phone (206) 323-0114

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20161003000087 WA Part B Supplier - Clinic/Group Practice 5991092124 Receives reassigned benefits from 1 practitioner
Practice locations: Bainbridge Island, WA

National Provider Directory

National Provider Directory

Locations

271 Wyatt Way NE
Ste 200
Bainbridge Island, WA 98110
Phone (206) 380-6366

1400 20th Ave
Seattle, WA 98122
Phone (206) 323-0114

Practitioners & affiliated clinicians

Practitioners 1

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": "1473724800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1474416000000",
    "number": "1164970778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 20TH AVE",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981222802",
            "telephone_number": "206-323-0114",
            "fax_number": "844-329-1722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 20TH AVE",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981222802",
            "telephone_number": "206-323-0114",
            "fax_number": "844-329-1722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL WELLNESS CHIROPRACTIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-13",
        "last_updated": "2016-09-21",
        "status": "A",
        "authorized_official_last_name": "WORD",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "OWNER/CHIROPRACTOR",
        "authorized_official_telephone_number": "206-323-0114",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor, Sports Physician",
            "state": "WA",
            "license": "CH60239267",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2016; 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.