Individual provider Active NPI

Jennifer Helene Sansen, DC

  • Chiropractor
  • Port Orchard, WA
National Provider Identifier
1265424220
Registry record updated Jun 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3048 Issued in WA
Practice address
200 Bethel Ave
Port Orchard, WA 98366-5216
Phone
(360) 876-4171
Fax
(360) 876-3495
NPI assigned
Aug 16, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 5, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3048 WA Primary

Addresses

Primary practice location

200 Bethel Ave
Port Orchard, WA 98366-5216

Mailing address

200 Bethel Ave
Port Orchard, WA 98366-5216
Phone (360) 876-4171

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110408000068 WA Practitioner - Chiropractic 6800787300 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dr Jennifer Sansen P SGroup PAC ID 8921999426, 2 clinicians

Practice addresses (Care Compare)

200 Bethel Ave
Port Orchard, WA 98366-5216
Phone (360) 876-4171

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3048WAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Jennifer Sansen, P.S. Chiropractor CurrentSince Aug 22, 1995 Accepting new patients
Kitsap Chiropractic Chiropractor PastSince Aug 15, 2002 Accepting new patients

Locations

200 Bethel Ave
Port Orchard, WA 98366
Phone (360) 876-4171

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": "1124150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1338854400000",
    "number": "1265424220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 BETHEL AVE",
            "city": "PORT ORCHARD",
            "state": "WA",
            "postal_code": "983665216",
            "telephone_number": "360-876-4171",
            "fax_number": "360-876-3495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 BETHEL AVE",
            "city": "PORT ORCHARD",
            "state": "WA",
            "postal_code": "983665216",
            "telephone_number": "360-876-4171",
            "fax_number": "360-876-3495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANSEN",
        "first_name": "JENNIFER",
        "middle_name": "HELENE",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-08-16",
        "last_updated": "2012-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "3048",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Orchard, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2012; 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.