Individual provider Active NPI

Brian Patrick Martin, D.C.

  • Chiropractor
  • Vancouver, WA
National Provider Identifier
1205949963
Registry record updated Jun 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH60610892 Issued in WA
Practice address
1825 SE 164TH Ave Ste 118
Vancouver, WA 98683-8602
Phone
(360) 524-7677
Fax
(360) 326-1668
NPI assigned
Aug 16, 2006
Last updated
Jun 22, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH60610892 WA Primary

Addresses

Primary practice location

1825 SE 164TH Ave Ste 118
Vancouver, WA 98683-8602

Mailing address

1825 SE 164TH Ave Ste 118
Vancouver, WA 98683-8602
Phone (360) 524-7677

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151204001510 WA Practitioner - Chiropractic 5294805727 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Western States College of Chiropractic, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Freeman Martin and Martin LLCGroup PAC ID 7113306788, 2 clinicians

Practice addresses (Care Compare)

1825 SE 164TH Ave
Suite 118
Vancouver, WA 98683-8602
Phone (360) 524-7677

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Opdahl Chiropractic Office Inc. Chiropractor CurrentSince Mar 15, 2021 Accepting new patients
Freeman, Martin & Martin LLC Chiropractor CurrentSince Mar 28, 2022 Accepting new patients
Life Force Chiropractic LLC Chiropractor CurrentSince Mar 27, 2022 Accepting new patients
Brian Martin Chiropractic Inc Chiropractor CurrentSince Nov 29, 2011 Accepting new patients
Schall Chiropractic Inc Chiropractor Past Accepting new patients
Advanced Health & Wellness PastSince Mar 1, 2010 Accepting new patients

Locations

44245 20th St W
Lancaster, CA 93534
Phone (661) 718-3870

840 Tucker Rd
Ste H
Tehachapi, CA 93561
Phone (661) 822-5004

105 N Parkway Ave
Ste 101
Battle Ground, WA 98604
Phone (360) 666-6001

1825 SE 164th Ave
Ste 118
Vancouver, WA 98683
Phone (360) 524-7677

Organizations & group practices 6

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": "1155686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655856000000",
    "number": "1205949963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1825 SE 164TH AVE STE 118",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986838602",
            "telephone_number": "360-524-7677",
            "fax_number": "360-326-1668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1825 SE 164TH AVE STE 118",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986838602",
            "telephone_number": "360-524-7677",
            "fax_number": "360-326-1668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "BRIAN",
        "middle_name": "PATRICK",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-16",
        "last_updated": "2022-06-22",
        "certification_date": "2022-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH60610892",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2022; 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.