Individual provider Active NPI

Jeffry Waldrop, D.C.

  • Sports Physician Chiropractor
  • Everett, WA
National Provider Identifier
1194802801
Registry record updated Oct 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Physician ChiropractorTaxonomy code 111NS0005X
License
60289583 Issued in WA
Practice address
11314 4TH Ave W
Suite 103
Everett, WA 98204-6926
Phone
(425) 355-3739
NPI assigned
Nov 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Physician Chiropractor 111NS0005X 2521 MA
Sports Physician Chiropractor 111NS0005X 60289583 WA Primary

Addresses

Primary practice location

11314 4TH Ave W
Suite 103
Everett, WA 98204-6926

Mailing address

11314 4TH Ave W
Suite 103
Everett, WA 98204-6926
Phone (425) 355-3739

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121207000473 WA Practitioner - Chiropractic 6305816786 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - West Sunnyvale, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Clearview Wellness Center PLLCGroup PAC ID 7517193287, 3 clinicians

Practice addresses (Care Compare)

17416 Sr
9 Suite B
Snohomish, WA 98296-6304
Phone (360) 668-2000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2521MAMDClinical Psychologist
60289583WAMDSports Physician Chiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Clearview Wellness Center, PLLC CurrentSince Sep 21, 2021 Accepting new patients
Jeffry W. Waldrop, P.C. Sports Physician PastSince Jul 31, 2004 Accepting new patients

Locations

17416 State Route 9 SE
Ste B
Snohomish, WA 98296
Phone (360) 668-2000

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349049600000",
    "number": "1194802801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11314 4TH AVE W",
            "address_2": "SUITE 103",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982046926",
            "telephone_number": "425-355-3739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11314 4TH AVE W",
            "address_2": "SUITE 103",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982046926",
            "telephone_number": "425-355-3739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALDROP",
        "first_name": "JEFFRY",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2012-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "MA",
            "license": "2521",
            "primary": false
        },
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "WA",
            "license": "60289583",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Everett, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2012; 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.