Lisa Nicole Fomenoff, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CH00034259 Issued in WA

Practice address

14777 NE 40TH St
Suite 102
Bellevue, WA 98007-3300

Phone

(425) 883-2543

Fax

(425) 867-1109

NPI assigned

Aug 9, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Ashley Antonoff, P.S.

  • Chiropractor
  • Bellevue, WA
  • NPI 1821008103
  NPD (past)

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

{
    "created_epoch": "1155081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1200873600000",
    "number": "1194735472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14777 NE 40TH ST",
            "address_2": "SUITE 102",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980073300",
            "telephone_number": "425-883-2543",
            "fax_number": "425-867-1109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14777 NE 40TH ST",
            "address_2": "SUITE 102",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980073300",
            "telephone_number": "425-883-2543",
            "fax_number": "425-867-1109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOMENOFF",
        "first_name": "LISA",
        "middle_name": "NICOLE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-09",
        "last_updated": "2008-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH00034259",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marcus Keating Flynn, DDS
• Nicole Michelle Flynn, LICSW
• Ashley Marie-Louise Fogwell, ASHLEY FOGWELL
• Amy Melissa Foley, AU.D.
• Anne Marie Fombu
• Carmen Fong
• Letasha Louise Footman
• Kyle Scott Forbes, DPT
• Mina Fordyce, O.D.
• John Fore, M.S.P.T.

• Chiropractor in Bellevue, WA
• Providers in Bellevue, WA by specialty
• Chiropractor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.