Individual provider Active NPI

Lowell Thomas Kovacich, DC, ATC

  • Chiropractor
  • Spokane Valley, WA
National Provider Identifier
1245813658
Registry record updated Aug 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
61578019 Issued in WA
Practice address
902 S Sullivan Rd
Spokane Valley, WA 99037-9754
Phone
(509) 922-1909
Fax
(509) 922-6648
NPI assigned
May 3, 2021
Reactivated
Jul 31, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X
Chiropractor 111N00000X 61578019 WA Primary

Addresses

Primary practice location

902 S Sullivan Rd
Spokane Valley, WA 99037-9754

Mailing address

902 S Sullivan Rd
Spokane Valley, WA 99037-9754
Phone (509) 833-1277

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
61578019WAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Peterson Orthopedics CurrentSince Aug 4, 2024 Accepting new patients
Asdrubal I Lopez, DC, PS CurrentSince Aug 4, 2024 Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/24613/brand/1/csg/1/fhir/r4

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": "1620000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722556800000",
    "number": "1245813658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "902 S SULLIVAN RD",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "990379754",
            "telephone_number": "509-833-1277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "902 S SULLIVAN RD",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "990379754",
            "telephone_number": "509-922-1909",
            "fax_number": "509-922-6648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOVACICH",
        "first_name": "LOWELL",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "DC, ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-03",
        "last_updated": "2024-08-02",
        "certification_date": "2024-08-02",
        "deactivation_date": "2024-07-15",
        "reactivation_date": "2024-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "61578019",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane Valley, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2024; 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.