Individual provider Active NPI

Kevin L Waugh, DC

  • Chiropractor
  • Seattle, WA
National Provider Identifier
1265507883
Registry record updated Jul 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH00034185 Issued in WA
Practice address
9776 Holman Rd NW #109
Seattle, WA 98117
Phone
(206) 782-8800
Fax
(206) 782-2777
NPI assigned
Nov 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 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 CH00034185 WA Primary

Addresses

Primary practice location

9776 Holman Rd NW #109
Seattle, WA 98117

Mailing address

9776 Holman Rd NW Ste 109
Seattle, WA 98117-2000
Phone (206) 782-8800

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071212000541 WA Practitioner - Chiropractic 4082704259 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - West Sunnyvale, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

10031 -B Holman Rd NW
Seattle, WA 98177-4920

10031 B Holman NW Rd
Seattle, WA 98177-4920
Phone (206) 782-8800

10031 B Holman Rd NW
Seattle, WA 98177-4920

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
KKW Inc Chiropractor CurrentSince Nov 1, 2008 Accepting new patients
Moss Chiropractic PC Chiropractor Past Accepting new patients

Locations

10031 Holman Rd NW
#B
Seattle, WA 98177
Phone (206) 782-8800

9776 Holman Rd NW
Ste 109
Seattle, WA 98117
Phone (206) 782-8800

10031B Holman Rd NW
Seattle, WA 98177

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": "1164067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342483200000",
    "number": "1265507883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9776 HOLMAN RD NW STE 109",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981172000",
            "telephone_number": "206-782-8800",
            "fax_number": "206-782-2777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9776 HOLMAN RD NW #109",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "98117",
            "telephone_number": "206-782-8800",
            "fax_number": "206-782-2777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAUGH",
        "first_name": "KEVIN",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-21",
        "last_updated": "2012-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH00034185",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Jul 17, 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.