Individual provider Active NPI

Kelly D Arnold, D.C.

  • Chiropractor
  • Bellingham, WA
National Provider Identifier
1174697791
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH00034542 Issued in WA
Practice address
3410 Woburn St # 202
Bellingham, WA 98226-5643
Phone
(360) 752-0061
NPI assigned
Nov 17, 2006
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 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 CH00034542 WA Primary

Addresses

Primary practice location

3410 Woburn St # 202
Bellingham, WA 98226-5643

Mailing address

1121 Sudden Vly
Bellingham, WA 98229-4829
Phone (360) 715-3465

Other identifiers 1

IdentifierTypeStateIssuer
2031896MedicaidWA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060418000110 WA Practitioner - Chiropractic 5991714115 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2005
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1151 Ellis St
Suite 104
Bellingham, WA 98225-5245
Phone (360) 752-0061

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH00034542WAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Barkley Chiropractic, PS Chiropractor CurrentSince Apr 1, 2006 Accepting new patients
Bellingham Performance Chiropractic LLC Chiropractor Past Accepting new patients

Locations

1151 Ellis St
Ste 104
Bellingham, WA 98225
Phone (360) 752-0061

3410 Woburn St
Ste 202
Bellingham, WA 98226
Phone (360) 738-8877

Organizations & group practices 2

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": "1163721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1174697791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1121 SUDDEN VLY",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982294829",
            "telephone_number": "360-715-3465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3410 WOBURN ST # 202",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982265643",
            "telephone_number": "360-752-0061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARNOLD",
        "first_name": "KELLY",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-17",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH00034542",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2031896",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellingham, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.