NPIMap

Organization Active NPI

Spinal Health Care Center

  • Chiropractor
  • Port Orchard, WA
National Provider Identifier
1457549016
Registry record updated May 26, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH3166 Issued in WA
Legal business name
SPINAL HEALTH CARE CENTER
Practice address
1386 SE Lund Ave
Suite 1
Port Orchard, WA 98366-5601
Phone
(360) 874-7494
Fax
(360) 874-0586
NPI assigned
Oct 9, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 26, 2010

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

Authorized official

Name
Dr. Douglas R Smith, D.C.NPI 1720195761
Title
Owner
Phone
(360) 874-7494

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
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X CH3166 WA Primary

Addresses

Primary practice location

1386 SE Lund Ave
Suite 1
Port Orchard, WA 98366-5601

Mailing address

1386 SE Lund Avenue
Suite 1
Port Orchard, WA 98366
Phone (360) 874-7494

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071212000614 WA Part B Supplier - Clinic/Group Practice 8921198102 Receives reassigned benefits from 1 practitioner
Practice locations: Silverdale, WA

National Provider Directory

National Provider Directory

Locations

1386 SE Lund Ave
Ste 1
Port Orchard, WA 98366
Phone (360) 874-7494

11871 Silverdale Way NW
Ste 109
Silverdale, WA 98383
Phone (360) 710-7491

Practitioners & affiliated clinicians

Practitioners 9

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": "1191888000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1274832000000",
    "number": "1457549016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1386 SE LUND AVENUE",
            "address_2": "SUITE 1",
            "city": "PORT ORCHARD",
            "state": "WA",
            "postal_code": "98366",
            "telephone_number": "360-874-7494",
            "fax_number": "360-874-0586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1386 SE LUND AVE",
            "address_2": "SUITE 1",
            "city": "PORT ORCHARD",
            "state": "WA",
            "postal_code": "983665601",
            "telephone_number": "360-874-7494",
            "fax_number": "360-874-0586"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPINAL HEALTH CARE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-09",
        "last_updated": "2010-05-26",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "360-874-7494",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH3166",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Orchard, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2010; 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.