Organization Active NPI

Bagby Chiropractic PLLC

  • Chiropractor
  • Renton, WA
National Provider Identifier
1417368507
Registry record updated May 12, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH000001865 Issued in WA
Legal business name
BAGBY CHIROPRACTIC PLLC
Practice address
435 SW 41St St
Renton, WA 98057-4926
Phone
(425) 251-9770
Fax
(425) 251-9846
NPI assigned
May 12, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 12, 2014

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

Authorized official

Name
Lorri Bagby
Title
Manager
Phone
(425) 251-9770

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X CH000001865 WA Primary

Addresses

Primary practice location

435 SW 41St St
Renton, WA 98057-4926

Mailing address

435 SW 41St St
Renton, WA 98057-4926
Phone (425) 251-9770

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20141014002117 WA Part B Supplier - Clinic/Group Practice 6709007826 Receives reassigned benefits from 1 practitioner
Practice locations: Renton, WA

National Provider Directory

National Provider Directory

Locations

435 SW 41st St
Renton, WA 98057
Phone (206) 251-9770

Practitioners & affiliated clinicians

Practitioners 1

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": "1399852800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1399852800000",
    "number": "1417368507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "435 SW 41ST ST",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980574926",
            "telephone_number": "425-251-9770",
            "fax_number": "425-251-9846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "435 SW 41ST ST",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980574926",
            "telephone_number": "425-251-9770",
            "fax_number": "425-251-9846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAGBY CHIROPRACTIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-12",
        "last_updated": "2014-05-12",
        "status": "A",
        "authorized_official_last_name": "BAGBY",
        "authorized_official_first_name": "LORRI",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "425-251-9770"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH000001865",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Renton, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2014; 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.