Organization Active NPI

Johnstone Chiropractic Inc PS

  • Chiropractor
  • Lake Stevens, WA
National Provider Identifier
1417120957
Registry record updated Apr 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH00003108 Issued in WA
Legal business name
JOHNSTONE CHIROPRACTIC INC PS
Practice address
515 State Route 9 NE
Suite 105
Lake Stevens, WA 98258-8523
Phone
(425) 334-1874
Fax
(425) 334-3852
NPI assigned
Apr 4, 2008
Last updated
Apr 13, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2011

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

Authorized official

Name
Dr. Jerry Stanley Johnston II, DC
Title
President
Phone
(425) 334-1874

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH00003108 WA Primary

Addresses

Primary practice location

515 State Route 9 NE
Suite 105
Lake Stevens, WA 98258-8523

Mailing address

515 State Route 9 NE
Suite 105
Lake Stevens, WA 98258-8523
Phone (425) 334-1874

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040406000620 WA Part B Supplier - Clinic/Group Practice 6305839317 Receives reassigned benefits from 1 practitioner
Practice locations: Lake Stevens, WA

National Provider Directory

National Provider Directory

Locations

515 State Route 9 NE
Ste 105
Lake Stevens, WA 98258
Phone (425) 334-1874

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1207267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1302652800000",
    "number": "1417120957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 STATE ROUTE 9 NE",
            "address_2": "SUITE 105",
            "city": "LAKE STEVENS",
            "state": "WA",
            "postal_code": "982588523",
            "telephone_number": "425-334-1874",
            "fax_number": "425-334-3852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 STATE ROUTE 9 NE",
            "address_2": "SUITE 105",
            "city": "LAKE STEVENS",
            "state": "WA",
            "postal_code": "982588523",
            "telephone_number": "425-334-1874",
            "fax_number": "425-334-3852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHNSTONE CHIROPRACTIC INC PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-04",
        "last_updated": "2011-04-13",
        "status": "A",
        "authorized_official_last_name": "JOHNSTON",
        "authorized_official_first_name": "JERRY",
        "authorized_official_middle_name": "STANLEY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "425-334-1874",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "II",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH00003108",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Stevens, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2011; 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.