NPIMap

Organization Active NPI

Mindbody Medicine PC

Doing business as Wedgwood Center for Natural Medicine

  • Chiropractor
  • Seattle, WA
National Provider Identifier
1255838298
Registry record updated Jun 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH60522163 Issued in WA
Legal business name
MINDBODY MEDICINE PC
Doing business as
Wedgwood Center for Natural Medicine
Practice address
2705 NE 65TH St
Seattle, WA 98115-7129
Phone
(206) 523-9000
Fax
(206) 523-5566
NPI assigned
Apr 6, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2018

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

Authorized official

Name
Dr. John Richard Chevigny, DCNPI 1669860052
Title
Clinic Director
Phone
(206) 523-9000

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 5

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X CH60522163 WA Primary
Rehabilitation ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111NR0400X CH60522163 WA
Sports Physician ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111NS0005X CH60522163 WA
AcupuncturistGroup: 193200000X MULTI-SPECIALTY GROUP 171100000X
Massage TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225700000X

Addresses

Primary practice location

2705 NE 65TH St
Seattle, WA 98115-7129

Mailing address

2028 43Rd Ave E Apt 2-4
Seattle, WA 98112-2758
Phone (206) 660-6085

Other identifiers 1

IdentifierTypeStateIssuer
1669860052OtherWANPI

Other names 1

  • Wedgwood Center for Natural Medicine Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180628003439 WA Part B Supplier - Clinic/Group Practice 0446506786 Receives reassigned benefits from 2 practitioners
Practice locations: Seattle, WA

National Provider Directory

National Provider Directory

Locations

2705 NE 65th St
Seattle, WA 98115
Phone (206) 414-9992

Practitioners & affiliated clinicians

Practitioners 14

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.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1522972800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529107200000",
    "number": "1255838298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2028 43RD AVE E APT 2-4",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981122758",
            "telephone_number": "206-660-6085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2705 NE 65TH ST",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981157129",
            "telephone_number": "206-523-9000",
            "fax_number": "206-523-5566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINDBODY MEDICINE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-06",
        "last_updated": "2018-06-16",
        "status": "A",
        "authorized_official_last_name": "CHEVIGNY",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "RICHARD",
        "authorized_official_title_or_position": "CLINIC DIRECTOR",
        "authorized_official_telephone_number": "206-523-9000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH60522163",
            "primary": true
        },
        {
            "code": "111NR0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor, Rehabilitation",
            "state": "WA",
            "license": "CH60522163",
            "primary": false
        },
        {
            "code": "111NS0005X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor, Sports Physician",
            "state": "WA",
            "license": "CH60522163",
            "primary": false
        },
        {
            "code": "171100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Acupuncturist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Massage Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1669860052",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wedgwood Center for Natural Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2018; 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.