NPIMap

Organization Active NPI

Clark Chiropractic

  • Chiropractor
  • Silverdale, WA
National Provider Identifier
1316959786
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1687 Issued in WA
Legal business name
CLARK CHIROPRACTIC
Practice address
9100 Silverdale Way NW
Silverdale, WA 98383-8389
Phone
(360) 692-1178
NPI assigned
Aug 13, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Stephen Ned Clark, DCNPI 1043249519
Title
Owner
Phone
(360) 692-1178

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 111N00000X 1687 WA Primary

Addresses

Primary practice location

9100 Silverdale Way NW
Silverdale, WA 98383-8389

Mailing address

9100 Silverdale Way NW
Silverdale, WA 98383-8389
Phone (360) 692-1178

Other identifiers 4

IdentifierTypeStateIssuer
5370CLOtherWAREG BS
54222OtherWA1ST CHOICE
184303OtherWAL&I PR#
1687OtherWALIC#

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040301000952 WA Part B Supplier - Clinic/Group Practice 0749177111 Receives reassigned benefits from 2 practitioners
Practice locations: Silverdale, WA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 16

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1155427200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1316959786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9100 SILVERDALE WAY NW",
            "city": "SILVERDALE",
            "state": "WA",
            "postal_code": "983838389",
            "telephone_number": "360-692-1178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9100 SILVERDALE WAY NW",
            "city": "SILVERDALE",
            "state": "WA",
            "postal_code": "983838389",
            "telephone_number": "360-692-1178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLARK CHIROPRACTIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "NED",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "360-692-1178",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "1687",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REG BS",
            "identifier": "5370CL",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "1ST CHOICE",
            "identifier": "54222",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I PR#",
            "identifier": "184303",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LIC#",
            "identifier": "1687",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Silverdale, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.