Thomas G Reardon D.C. P.S.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CH00002695 Issued in WA

Legal business name

THOMAS G REARDON D.C. P.S.

Doing business as

The Back Doctor

Practice address

1717 NE 44TH St
Suite G
Renton, WA 98056-9001

Phone

(425) 277-4098

Fax

(425) 277-8239

NPI assigned

Jan 9, 2007

Last updated

Oct 22, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Thomas Reardon, D.C.NPI 1376722587

Title

P.S.

Phone

(425) 277-4098

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• The Back Doctor Doing business as

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Thomas G Reardon, D.C.

  • Chiropractor
  • Renton, WA
  • NPI 1376722587
  Medicare reassignment Care Compare group NPD Authorized official
• Gabriel Alban Reardon, DC

  • Chiropractor
  • Renton, WA
  • NPI 1396411625
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193011200000",
    "number": "1366591331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1717 NE 44TH ST",
            "address_2": "SUITE G",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980569001",
            "telephone_number": "425-277-4098",
            "fax_number": "425-277-8239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 NE 44TH ST",
            "address_2": "SUITE G",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980569001",
            "telephone_number": "425-277-4098",
            "fax_number": "425-277-8239"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THOMAS G REARDON D.C. P.S.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-09",
        "last_updated": "2007-10-22",
        "status": "A",
        "authorized_official_last_name": "REARDON",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "P.S.",
        "authorized_official_telephone_number": "425-277-4098",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH00002695",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEP. OF L & I",
            "identifier": "39743",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUE SHIELD",
            "identifier": "RE2839",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Back Doctor",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Jason H Thompson, M.D.
• Jeffrey C Thompson, MD

• Chiropractor in Renton, WA
• Providers in Renton, WA by specialty
• Chiropractor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2007; 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.