Phillip M. Padelford, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CH00001161 Issued in WA

Practice address

609 39TH Ave SW
Puyallup, WA 98373-5917

Phone

(253) 848-6626

Fax

(253) 848-6937

NPI assigned

Nov 10, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Dr. Phillip M Padelford Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Lifestyle Chiropractic PLLC

  • Chiropractor
  • Puyallup, WA
  • NPI 1619747300
  NPD

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

{
    "created_epoch": "1163116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403049600000",
    "number": "1457422727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 73575",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983730575",
            "telephone_number": "253-848-6626",
            "fax_number": "253-848-6937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "609 39TH AVE SW",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983735917",
            "telephone_number": "253-848-6626",
            "fax_number": "253-848-6937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PADELFORD",
        "first_name": "PHILLIP",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-10",
        "last_updated": "2014-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH00001161",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR & INDUSTRY ID #",
            "identifier": "30383",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PHILLIP",
            "last_name": "PADELFORD",
            "middle_name": "M",
            "prefix": "DR.",
            "credential": "D.C.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Chiropractor in Puyallup, WA
• Providers in Puyallup, WA by specialty
• Chiropractor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.