Active NPI
Kenneth Eugene Ely, D.C.
- Chiropractor
- Blaine, WA
National Provider Identifier
1346394400
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 1485
- Practice address
- 365 H St
Blaine, WA 98230-4109 - Phone
- (360) 332-4730
- Fax
- (360) 332-3309
- NPI assigned
- Jan 23, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 1485 | WA | Primary |
Addresses
Primary practice location
365 H St
Blaine, WA 98230-4109
Mailing address
399 H St
Ste 2
Blaine, WA 98230-4100
Phone (360) 332-4730
Other identifiers 7
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 360320000 | Other | WA | BCBS |
| 91-1218101 | Other | WA | FED EMP. ID # |
| 2065308 | Other | WA | DSHS |
| 7785313 | Other | WA | AETNA |
| 350019617 | Other | WA | PALMETTO RAIL MED. |
| 34345 | Other | WA | DEPT. OF LABOR & INDUST. |
| 1668403003 | Other | WA | CIGNA PAL |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 1485 | WA | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169510400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1475539200000",
"number": "1346394400",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "399 H ST",
"address_2": "STE 2",
"city": "BLAINE",
"state": "WA",
"postal_code": "982304100",
"telephone_number": "360-332-4730",
"fax_number": "360-332-3309"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "365 H ST",
"city": "BLAINE",
"state": "WA",
"postal_code": "982304109",
"telephone_number": "360-332-4730",
"fax_number": "360-332-3309"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELY",
"first_name": "KENNETH",
"middle_name": "EUGENE",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-23",
"last_updated": "2016-10-04",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "WA",
"license": "1485",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "360320000",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FED EMP. ID #",
"identifier": "91-1218101",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DSHS",
"identifier": "2065308",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "7785313",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PALMETTO RAIL MED.",
"identifier": "350019617",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DEPT. OF LABOR & INDUST.",
"identifier": "34345",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA PAL",
"identifier": "1668403003",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Blaine, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 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.