NPIMap

Organization Active NPI

Back in Motion Chiropractic P.C.

Doing business as Back In Motion Chiropractic

  • Chiropractor
  • Olympia, WA
National Provider Identifier
1184828618
Registry record updated Jun 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH00003654 Issued in WA
Legal business name
BACK IN MOTION CHIROPRACTIC P.C.
Doing business as
Back In Motion Chiropractic
Practice address
1115 Black Lake Blvd SW Ste a
Olympia, WA 98502-1026
Phone
(360) 357-7585
Fax
(360) 236-0649
NPI assigned
Jun 11, 2007
Last updated
Jun 18, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2008

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

Authorized official

Name
Dr. Donald Michael Soran, D.C.NPI 1164503256
Title
President
Phone
(360) 357-7585

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
Chiropractor 111N00000X CH00003654 WA Primary

Addresses

Primary practice location

1115 Black Lake Blvd SW Ste a
Olympia, WA 98502-1026

Mailing address

1115 Black Lake Blvd SW Ste a
Olympia, WA 98502-1026
Phone (360) 357-7585

Other identifiers 3

IdentifierTypeStateIssuer
125645OtherWAGROUP L&I
CH00003654OtherWASTATE LICENCE
125644OtherWAINDAVIDUAL L&I

Other names 1

  • Back In Motion Chiropractic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120306000112 WA Part B Supplier - Clinic/Group Practice 9830358209 Receives reassigned benefits from 1 practitioner
Practice locations: Olympia, WA

National Provider Directory

National Provider Directory

Locations

1115 Black Lake Blvd SW
Ste A
Olympia, WA 98502
Phone (360) 357-7585

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1181520000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213747200000",
    "number": "1184828618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1115 BLACK LAKE BLVD SW STE A",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985021026",
            "telephone_number": "360-357-7585",
            "fax_number": "360-236-0649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1115 BLACK LAKE BLVD SW STE A",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985021026",
            "telephone_number": "360-357-7585",
            "fax_number": "360-236-0649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BACK IN MOTION CHIROPRACTIC P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-11",
        "last_updated": "2008-06-18",
        "status": "A",
        "authorized_official_last_name": "SORAN",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "360-357-7585",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH00003654",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP L&I",
            "identifier": "125645",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENCE",
            "identifier": "CH00003654",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDAVIDUAL L&I",
            "identifier": "125644",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Back In Motion Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Olympia, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2008; 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.