NPIMap

Organization Active NPI

Dynamic Chiropractic Clinic of Bellevue PLLC

Doing business as Dynamic Chiros

  • Chiropractor
  • Redmond, WA
National Provider Identifier
1225256407
Registry record updated Feb 7, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH00034040 Issued in WA
Legal business name
DYNAMIC CHIROPRACTIC CLINIC OF BELLEVUE PLLC
Doing business as
Dynamic Chiros
Practice address
15230 NE 24TH St Ste 1-S
Redmond, WA 98052-5540
Phone
(425) 827-2225
Fax
(425) 283-4192
NPI assigned
Apr 23, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2013

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

Authorized official

Name
Dr. Mark Thompson, DCNPI 1467460501
Title
Owner
Phone
(425) 827-2225

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: 193200000X MULTI-SPECIALTY GROUP 111N00000X CH00034040 WA Primary

Addresses

Primary practice location

15230 NE 24TH St Ste 1-S
Redmond, WA 98052-5540

Mailing address

15230 NE 24TH St Ste 1-S
Redmond, WA 98052-5540
Phone (425) 827-2225

Other names 1

  • Dynamic Chiros Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041116001007 WA Part B Supplier - Clinic/Group Practice 9931163227 Receives reassigned benefits from 3 practitioners
Practice locations: Redmond, WA

National Provider Directory

National Provider Directory

Locations

15650 NE 24th St
Ste E
Bellevue, WA 98008
Phone (425) 746-8073

15230 NE 24th St
Ste 1S
Redmond, WA 98052
Phone (425) 827-2225

Practitioners & affiliated clinicians

Practitioners 12

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": "1177286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1360195200000",
    "number": "1225256407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15230 NE 24TH ST STE 1-S",
            "city": "REDMOND",
            "state": "WA",
            "postal_code": "980525540",
            "telephone_number": "425-827-2225",
            "fax_number": "425-283-4192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15230 NE 24TH ST STE 1-S",
            "city": "REDMOND",
            "state": "WA",
            "postal_code": "980525540",
            "telephone_number": "425-827-2225",
            "fax_number": "425-283-4192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DYNAMIC CHIROPRACTIC CLINIC OF BELLEVUE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-23",
        "last_updated": "2013-02-07",
        "status": "A",
        "authorized_official_last_name": "THOMPSON",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "425-827-2225",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH00034040",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dynamic Chiros",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Redmond, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2013; 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.