Sally Jane PS

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

SALLY JANE PS

Practice address

1101 8TH St
Suite B
Anacortes, WA 98221-1800

Phone

(360) 982-2881

Fax

(360) 899-5846

NPI assigned

Apr 12, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Robert Niles Kelley, DCNPI 1801974092

Title

Owner

Phone

(360) 982-2881

Specialties & licenses 1

Addresses

Other names 1

• Gateway Chiropractic Center Doing business as

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Robert Niles Kelley, DC

  • Chiropractor
  • Anacortes, WA
  • NPI 1801974092
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1550361600000",
    "number": "1235353897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 8TH ST",
            "address_2": "SUITE B",
            "city": "ANACORTES",
            "state": "WA",
            "postal_code": "982211800",
            "telephone_number": "360-982-2881",
            "fax_number": "360-899-5846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 8TH ST",
            "address_2": "SUITE B",
            "city": "ANACORTES",
            "state": "WA",
            "postal_code": "982211800",
            "telephone_number": "360-982-2881",
            "fax_number": "360-899-5846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SALLY JANE PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-12",
        "last_updated": "2019-02-17",
        "status": "A",
        "authorized_official_last_name": "KELLEY",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "NILES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "360-982-2881",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gateway Chiropractic Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2019; 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.