NPIMap

Organization Active NPI

SCR PS

Doing business as Ultra Chiropractic

  • Chiropractor
  • Seattle, WA
National Provider Identifier
1447296819
Registry record updated Feb 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH00033629 Issued in WA
Legal business name
SCR PS
Doing business as
Ultra Chiropractic
Practice address
1100 NE 47TH St
Suite 101
Seattle, WA 98105-4686
Phone
(206) 527-0123
Fax
(206) 527-0133
NPI assigned
Jun 22, 2006
Last updated
Feb 23, 2015By the provider in NPPES
Organization subpart
Yes
Parent organization
SCR PSAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 23, 2015

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

Authorized official

Name
Dr. Shaun Richard Reynolds, D.C.NPI 1679507222
Title
Owner/Chiropractor
Phone
(206) 527-0123

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 CH00033629 WA Primary

Addresses

Primary practice location

1100 NE 47TH St
Suite 101
Seattle, WA 98105-4686

Mailing address

1100 NE 47TH St
Suite 101
Seattle, WA 98105-4686
Phone (206) 527-0123

Other names 1

  • Ultra Chiropractic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041130001143 WA Part B Supplier - Clinic/Group Practice 9335104413 Receives reassigned benefits from 4 practitioners
Practice locations: Lynnwood, WA; Seattle, WA

National Provider Directory

National Provider Directory
Part of
SCR PS

Practitioners & affiliated clinicians

Practitioners 15

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 15

NPI Registry JSON

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

{
    "created_epoch": "1150934400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1424649600000",
    "number": "1447296819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 NE 47TH ST",
            "address_2": "SUITE 101",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981054686",
            "telephone_number": "206-527-0123",
            "fax_number": "206-527-0133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 NE 47TH ST",
            "address_2": "SUITE 101",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981054686",
            "telephone_number": "206-527-0123",
            "fax_number": "206-527-0133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SCR PS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SCR PS",
        "enumeration_date": "2006-06-22",
        "last_updated": "2015-02-23",
        "status": "A",
        "authorized_official_last_name": "REYNOLDS",
        "authorized_official_first_name": "SHAUN",
        "authorized_official_middle_name": "RICHARD",
        "authorized_official_title_or_position": "OWNER/CHIROPRACTOR",
        "authorized_official_telephone_number": "206-527-0123",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH00033629",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ultra Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2015; 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.