Individual provider Active NPI

Charles M Laycock, DC

  • Chiropractor
  • Des Moines, WA
National Provider Identifier
1295853588
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2398 Issued in WA
Practice address
614 S 225TH St
Des Moines, WA 98198-6843
Phone
(206) 878-2225
Fax
(206) 878-7488
NPI assigned
Mar 26, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2398 WA Primary

Addresses

Primary practice location

614 S 225TH St
Des Moines, WA 98198-6843

Mailing address

614 S 225TH St
Des Moines, WA 98198-6843
Phone (206) 878-2225

Other identifiers 2

IdentifierTypeStateIssuer
2398OtherWAWA STATE LICENSE NUMBER
60683OtherWADEPT. OF L&I NUMBER

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051129000428 WA Practitioner - Chiropractic 3375563182 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - West Sunnyvale, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

614 S 225TH St
Des Moines, WA 98198-6843
Phone (206) 878-2225

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2398WAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Today'S Chiropractic Clinic, P.S. Chiropractor CurrentSince Sep 28, 2005 Accepting new patients

Locations

614 S 225th St
Des Moines, WA 98198
Phone (206) 878-2225

Organizations & group practices 1

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": "1174867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1295853588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "614 S 225TH ST",
            "city": "DES MOINES",
            "state": "WA",
            "postal_code": "981986843",
            "telephone_number": "206-878-2225",
            "fax_number": "206-878-7488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "614 S 225TH ST",
            "city": "DES MOINES",
            "state": "WA",
            "postal_code": "981986843",
            "telephone_number": "206-878-2225",
            "fax_number": "206-878-7488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAYCOCK",
        "first_name": "CHARLES",
        "middle_name": "M",
        "name_prefix": "Mr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "2398",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WA STATE LICENSE NUMBER",
            "identifier": "2398",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT. OF L&I NUMBER",
            "identifier": "60683",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Des Moines, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.