Active NPI
David Warren Middendorf, D.C.
- Chiropractor
- Port Orchard, WA
National Provider Identifier
1366483737
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- CH1706
- Practice address
- 4255 SE Mile Hill Dr
Suite101
Port Orchard, WA 98366-3920 - Phone
- (360) 871-5200
- Fax
- (360) 871-5350
- NPI assigned
- Jun 9, 2006
- 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 | CH1706 | WA | Primary |
Addresses
Primary practice location
4255 SE Mile Hill Dr
Suite101
Port Orchard, WA 98366-3920
Mailing address
PO Box 525
Port Orchard, WA 98366-0525
Phone (360) 871-5200
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 |
|---|---|---|---|
| CH1706 | WA | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149811200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1324512000000",
"number": "1366483737",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 525",
"city": "PORT ORCHARD",
"state": "WA",
"postal_code": "983660525",
"telephone_number": "360-871-5200",
"fax_number": "360-871-5350"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4255 SE MILE HILL DR",
"address_2": "SUITE101",
"city": "PORT ORCHARD",
"state": "WA",
"postal_code": "983663920",
"telephone_number": "360-871-5200",
"fax_number": "360-871-5350"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MIDDENDORF",
"first_name": "DAVID",
"middle_name": "WARREN",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-06-09",
"last_updated": "2011-12-22",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "WA",
"license": "CH1706",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Port Orchard, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.