NPIMap

Organization Active NPI

Bmi DC PS

  • Chiropractor
  • Mill Creek, WA
National Provider Identifier
1366512337
Registry record updated Oct 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH00003582 Issued in WA
Legal business name
BMI DC PS
Practice address
1700 132ND St SE Ste C
Mill Creek, WA 98012-5309
Phone
(425) 338-1555
Fax
(425) 338-0765
NPI assigned
Nov 8, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2022

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

Authorized official

Name
Fernanda Velderrain
Title
Office Manager
Phone
(425) 338-1555

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X CH00003582 WA Primary

Addresses

Primary practice location

1700 132ND St SE Ste C
Mill Creek, WA 98012-5309

Mailing address

1700 132ND St SE Ste L
Mill Creek, WA 98012-5309
Phone (425) 338-1555

Other names 1

  • Innovative Chiropractic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050809000999 WA Part B Supplier - Clinic/Group Practice 2264461383 Receives reassigned benefits from 1 practitioner
Practice locations: Mill Creek, WA

National Provider Directory

National Provider Directory

Locations

1700 132nd St SE
Ste L
Mill Creek, WA 98012
Phone (425) 338-1555

1700 132nd St SE
Ste C
Mill Creek, WA 98012
Phone (425) 338-1555

Practitioners & affiliated clinicians

Practitioners 10

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

NPI Registry JSON

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

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1664928000000",
    "number": "1366512337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 132ND ST SE STE L",
            "city": "MILL CREEK",
            "state": "WA",
            "postal_code": "980125309",
            "telephone_number": "425-338-1555",
            "fax_number": "425-338-0765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 132ND ST SE STE C",
            "city": "MILL CREEK",
            "state": "WA",
            "postal_code": "980125309",
            "telephone_number": "425-338-1555",
            "fax_number": "425-338-0765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BMI DC PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-08",
        "last_updated": "2022-10-05",
        "certification_date": "2022-10-05",
        "status": "A",
        "authorized_official_last_name": "VELDERRAIN",
        "authorized_official_first_name": "FERNANDA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "425-338-1555"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH00003582",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Innovative Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Innovative Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mill Creek, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2022; 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.