NPIMap

Organization Active NPI

Champion Family Chiropractic,

  • Chiropractor
  • Chewelah, WA
National Provider Identifier
1427045566
Registry record updated Dec 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH00033990 Issued in WA
Legal business name
CHAMPION FAMILY CHIROPRACTIC,
Practice address
103 E Main Ave
Chewelah, WA 99109-8960
Phone
(509) 935-2225
Fax
(509) 935-2273
NPI assigned
Oct 4, 2005
Last updated
Dec 2, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2008

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

Authorized official

Name
Dr. John R Champion, D.C.NPI 1942309687
Title
Owner
Phone
(509) 935-2225

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH00033990 WA Primary

Addresses

Primary practice location

103 E Main Ave
Chewelah, WA 99109-8960

Mailing address

PO Box 203
Chewelah, WA 99109-0203
Phone (509) 935-2225

Other identifiers 2

IdentifierTypeStateIssuer
0144619OtherWAWORK COMP
2024990MedicaidWA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040415001247 WA Part B Supplier - Clinic/Group Practice 6002801412 Receives reassigned benefits from 1 practitioner
Practice locations: Chewelah, WA

National Provider Directory

National Provider Directory

Locations

103 E Main Ave
Chewelah, WA 99109
Phone (509) 935-2225

Practitioners & affiliated clinicians

Practitioners 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1128384000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1228176000000",
    "number": "1427045566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 203",
            "city": "CHEWELAH",
            "state": "WA",
            "postal_code": "991090203",
            "telephone_number": "509-935-2225",
            "fax_number": "509-935-2273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 E MAIN AVE",
            "city": "CHEWELAH",
            "state": "WA",
            "postal_code": "991098960",
            "telephone_number": "509-935-2225",
            "fax_number": "509-935-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHAMPION FAMILY CHIROPRACTIC,",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-04",
        "last_updated": "2008-12-02",
        "status": "A",
        "authorized_official_last_name": "CHAMPION",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "509-935-2225",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH00033990",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WORK COMP",
            "identifier": "0144619",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2024990",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chewelah, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2008; 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.