Individual provider Active NPI

Mark Thompson

  • Chiropractor
  • Redmond, WA
National Provider Identifier
1467460501
Registry record updated Feb 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH00034040 Issued in WA
Practice address
15230 NE 24TH St Ste 1-S
Redmond, WA 98052-5540
Phone
(425) 827-2225
Fax
(425) 283-4192
NPI assigned
Aug 4, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 1, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH00034040 WA Primary

Addresses

Primary practice location

15230 NE 24TH St Ste 1-S
Redmond, WA 98052-5540

Mailing address

15230 NE 24TH St Ste 1-S
Redmond, WA 98052-5540
Phone (425) 827-2225

Other identifiers 1

IdentifierTypeStateIssuer
188390OtherWAL&I NUMBER

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041012000342 WA Practitioner - Chiropractic 8325008782 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dynamic Chiropractic Clinic of Bellevue PLLCGroup PAC ID 9931163227, 2 clinicians

Practice addresses (Care Compare)

15230 NE 24TH St
Suite 1 S
Redmond, WA 98052-5540
Phone (425) 827-2225

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH00034040WAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Dynamic Chiropractic Clinic of Bellevue PLLC Chiropractor CurrentSince Sep 1, 2004 Accepting new patients
Wellness Group Physical Therapy, PLLC Chiropractor PastSince Aug 1, 2020 Accepting new patients
Bothell Regenerative Medicine Past Accepting new patients
Kaufman Chiropractic Clinic Inc Chiropractor PastSince Feb 18, 2013 Accepting new patients
Dynamo Clinic PLLC Chiropractor Past Accepting new patients

Locations

15230 NE 24th St
Ste 1S
Redmond, WA 98052
Phone (425) 827-2225

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359676800000",
    "number": "1467460501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15230 NE 24TH ST STE 1-S",
            "city": "REDMOND",
            "state": "WA",
            "postal_code": "980525540",
            "telephone_number": "425-827-2225",
            "fax_number": "425-283-4192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15230 NE 24TH ST STE 1-S",
            "city": "REDMOND",
            "state": "WA",
            "postal_code": "980525540",
            "telephone_number": "425-827-2225",
            "fax_number": "425-283-4192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "MARK",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-04",
        "last_updated": "2013-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH00034040",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I NUMBER",
            "identifier": "188390",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Redmond, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.