NPIMap

Organization Active NPI

Intelligent Balance Chiropractic Spinal Care, PLLC

  • Chiropractor
  • Liberty Lake, WA
National Provider Identifier
1437515343
Registry record updated Jan 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
603434488 Issued in WA
Legal business name
INTELLIGENT BALANCE CHIROPRACTIC SPINAL CARE, PLLC
Practice address
2310 N Molter Rd Ste 108
Liberty Lake, WA 99019-8621
Phone
(509) 924-4443
Fax
(509) 924-1249
NPI assigned
Jan 7, 2016
Last updated
Jan 7, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2016

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

Authorized official

Name
Kimberly White, D.C.NPI 1124380589
Title
Owner
Phone
(509) 924-4443

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 603434488 WA Primary

Addresses

Primary practice location

2310 N Molter Rd Ste 108
Liberty Lake, WA 99019-8621

Mailing address

2310 N Molter Rd Ste 108
Liberty Lake, WA 99019-8621
Phone (509) 924-4443

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170208002960 WA Part B Supplier - Clinic/Group Practice 8628351004 Receives reassigned benefits from 3 practitioners
1 other NPI on this enrollment
Practice locations: Liberty Lake, WA; Republic, WA

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Intelligent Balance Chiropractic Spinal Care PLLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 3

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": "1452124800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1452124800000",
    "number": "1437515343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2310 N MOLTER RD STE 108",
            "city": "LIBERTY LAKE",
            "state": "WA",
            "postal_code": "990198621",
            "telephone_number": "509-924-4443",
            "fax_number": "509-924-1249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2310 N MOLTER RD STE 108",
            "city": "LIBERTY LAKE",
            "state": "WA",
            "postal_code": "990198621",
            "telephone_number": "509-924-4443",
            "fax_number": "509-924-1249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTELLIGENT BALANCE CHIROPRACTIC SPINAL CARE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-07",
        "last_updated": "2016-01-07",
        "status": "A",
        "authorized_official_last_name": "WHITE",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "509-924-4443",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "603434488",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Liberty Lake, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2016; 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.