Kerry Alan Bateman, D.C. – Chiropractor in Sumner, WA

Key facts

NPI: 1285704833
Entity type: Individual (NPI type 1)
Primary specialty: Chiropractor 111N00000X
License: CH00002090 (WA)
Practice address: 603 Hunt Ave
Suite a
Sumner, WA 98390-1117
Phone: (253) 863-0855
Fax: (253) 826-0511
NPI assigned: Nov 9, 2006
Sex: Male
Sole proprietor: Yes

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): Yes

State licenses

License	State	Type	Specialty
CH00002090	WA	MD	Chiropractor

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Chiropractor	111N00000X	CH00002090	WA	Yes

Addresses

Primary practice location

603 Hunt Ave
Suite a
Sumner, WA 98390-1117

Mailing address

603 Hunt Ave
Suite a
Sumner, WA 98390-1117
Phone (253) 863-0855

Other identifiers

Identifier	Type	State	Issuer
0005128	Other	WA	DEPT. OF LABOR AND INDUST
BA3922	Other	WA	REGENCE BLUESHIELD

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jan 17, 2008.

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1200528000000",
    "number": "1285704833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "603 HUNT AVE",
            "address_2": "SUITE A",
            "city": "SUMNER",
            "state": "WA",
            "postal_code": "983901117",
            "telephone_number": "253-863-0855",
            "fax_number": "253-826-0511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "603 HUNT AVE",
            "address_2": "SUITE A",
            "city": "SUMNER",
            "state": "WA",
            "postal_code": "983901117",
            "telephone_number": "253-863-0855",
            "fax_number": "253-826-0511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BATEMAN",
        "first_name": "KERRY",
        "middle_name": "ALAN",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-09",
        "last_updated": "2008-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH00002090",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT. OF LABOR AND INDUST",
            "identifier": "0005128",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUESHIELD",
            "identifier": "BA3922",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sumner, WA

All providers in Sumner, WA · Chiropractor in Washington

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 17, 2008. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.