Individual provider Active NPI

John E. Duppenthaler, D.C.

  • Chiropractor
  • Gig Harbor, WA
National Provider Identifier
1407972540
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Practice address
6659 Kimball Dr
Suite a-102
Gig Harbor, WA 98335-5137
Phone
(253) 857-9100
Fax
(253) 857-3110
NPI assigned
Mar 21, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X WA Primary

Addresses

Primary practice location

6659 Kimball Dr
Suite a-102
Gig Harbor, WA 98335-5137

Mailing address

6659 Kimball Dr
Suite a-102
Gig Harbor, WA 98335-5137
Phone (253) 857-9100

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071017000329 WA Practitioner - Chiropractic 8224124649 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College - West, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

6565 Kimball Dr
Suite 101
Gig Harbor, WA 98335-1269
Phone (253) 857-9100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH000002479WAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Colvill Chiropractic, Inc Chiropractor PastSince Mar 24, 2019 Accepting new patients
Walter Scott D.C., Inc. Chiropractor Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1407972540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6659 KIMBALL DR",
            "address_2": "SUITE A-102",
            "city": "GIG HARBOR",
            "state": "WA",
            "postal_code": "983355137",
            "telephone_number": "253-857-9100",
            "fax_number": "253-857-3110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6659 KIMBALL DR",
            "address_2": "SUITE A-102",
            "city": "GIG HARBOR",
            "state": "WA",
            "postal_code": "983355137",
            "telephone_number": "253-857-9100",
            "fax_number": "253-857-3110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUPPENTHALER",
        "first_name": "JOHN",
        "middle_name": "E.",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gig Harbor, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.