Individual provider Active NPI

Michael Shane Braccio, D.C.

  • Chiropractor
  • Seattle, WA
National Provider Identifier
1275874455
Registry record updated Aug 24, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH60269620 Issued in WA
Practice address
1656 E Olive Way
Seattle, WA 98102-5627
Phone
(206) 324-0981
NPI assigned
Mar 12, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 24, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH60269620 WA Primary

Addresses

Primary practice location

1656 E Olive Way
Seattle, WA 98102-5627

Mailing address

1656 E Olive Way
Seattle, WA 98102-5627
Phone (206) 324-0981

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH60269620WAMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1363046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471996800000",
    "number": "1275874455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1656 E OLIVE WAY",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981025627",
            "telephone_number": "206-324-0981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1656 E OLIVE WAY",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981025627",
            "telephone_number": "206-324-0981"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRACCIO",
        "first_name": "MICHAEL",
        "middle_name": "SHANE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-03-12",
        "last_updated": "2016-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH60269620",
            "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 Aug 24, 2016; 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.