Organization Active NPI

Integrative Chiropractic and Extremities

  • Chiropractor
  • Kennewick, WA
National Provider Identifier
1184157828
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
INTEGRATIVE CHIROPRACTIC AND EXTREMITIES
Practice address
7101 W Hood PL
Suite A101
Kennewick, WA 99336-6700
Phone
(509) 820-3828
NPI assigned
Apr 10, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Kyle D Bryant, DCNPI 1598187023
Title
Owner
Phone
(509) 820-3828

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 SINGLE SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

7101 W Hood PL
Suite A101
Kennewick, WA 99336-6700

Mailing address

7101 W Hood PL
Suite A101
Kennewick, WA 99336-6700
Phone (509) 820-3828

Other identifiers 1

IdentifierTypeStateIssuer
CH60418028OtherWALICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170830002170 WA Part B Supplier - Clinic/Group Practice 4385917137 Receives reassigned benefits from 3 practitioners
Practice locations: Kennewick, WA

National Provider Directory

National Provider Directory

Locations

7101 W Hood Pl
Ste A101
Kennewick, WA 99336
Phone (509) 581-3100

7117 W Hood Pl
Ste 130
Kennewick, WA 99336
Phone (509) 820-3828

Practitioners & affiliated clinicians

Practitioners 4

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": "1491782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1184157828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7101 W HOOD PL",
            "address_2": "SUITE A101",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993366700",
            "telephone_number": "509-820-3828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7101 W HOOD PL",
            "address_2": "SUITE A101",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993366700",
            "telephone_number": "509-820-3828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATIVE CHIROPRACTIC AND EXTREMITIES",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-10",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "BRYANT",
        "authorized_official_first_name": "KYLE",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "509-820-3828",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "CH60418028",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kennewick, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.