Individual provider Active NPI

Nicholas Scott Johnson, D.C.

  • Chiropractor
  • Kirkland, WA
National Provider Identifier
1285029637
Registry record updated Apr 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
60534944 Issued in WA
Practice address
11902 97TH Ave NE
Kirkland, WA 98034-1882
Phone
(425) 821-4600
NPI assigned
Apr 2, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 60534944 WA Primary

Addresses

Primary practice location

11902 97TH Ave NE
Kirkland, WA 98034-1882

Mailing address

13623 94TH Ave NE
Kirkland, WA 98034-1843
Phone (763) 607-8332

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220926002298 FL Practitioner - Chiropractic 3476812710 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Northwestern College of Chiropractic, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lifeclinic Physical Therapy and Chiropractic LLCGroup PAC ID 7214222793, 5 clinicians

Practice addresses (Care Compare)

237 S Dixie Hwy
Coral Gables, FL 33133-4824
Phone (786) 437-4458

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
60534944WAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Kitsap Medical Supply, LLC CurrentSince May 17, 2020 Accepting new patients
Lifeclinic Physical Therapy & Chiropractic LLC Chiropractor CurrentSince Jul 23, 2022 Accepting new patients
Ryan Coogan DC PS Chiropractor PastSince May 24, 2004 Accepting new patients

Locations

1499 W Yamato Rd
Boca Raton, FL 33431
Phone (561) 208-5900

237 S Dixie Hwy
Coral Gables, FL 33133
Phone (786) 322-5603

3595 NW Bucklin Hill Rd
Silverdale, WA 98383
Phone (360) 698-3140

Organizations & group practices 3

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": "1427932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427932800000",
    "number": "1285029637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13623 94TH AVE NE",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980341843",
            "telephone_number": "763-607-8332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11902 97TH AVE NE",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980341882",
            "telephone_number": "425-821-4600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "NICHOLAS",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-02",
        "last_updated": "2015-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "60534944",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kirkland, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2015; 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.