Organization Active NPI

Sillito Chiropractic Center, PS

  • Chiropractor
  • Puyallup, WA
National Provider Identifier
1467542274
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1192 Issued in WA
Legal business name
SILLITO CHIROPRACTIC CENTER, PS
Practice address
5511 112TH Avenue CT E
Suite B
Puyallup, WA 98372-5942
Phone
(253) 845-4655
Fax
(253) 845-1052
NPI assigned
Oct 13, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Derrol M. Sillito, D.C.NPI 1992704910
Title
President
Phone
(253) 845-4655

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 1192 WA Primary

Addresses

Primary practice location

5511 112TH Avenue CT E
Suite B
Puyallup, WA 98372-5942

Mailing address

5511 112TH Avenue CT E
Suite B
Puyallup, WA 98372-5942
Phone (253) 845-4655

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20061108000116 WA Part B Supplier - Clinic/Group Practice 4688671589 Receives reassigned benefits from 2 practitioners
Practice locations: Edgewood, WA

National Provider Directory

National Provider Directory

Locations

2908 Meridian Ave E
Ste 101
Edgewood, WA 98371
Phone (253) 318-6570

5511 112th Ave E
#B
Puyallup, WA 98372
Phone (253) 845-4655

Practitioners & affiliated clinicians

Practitioners 2

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": "1160697600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1467542274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5511 112TH AVENUE CT E",
            "address_2": "SUITE B",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983725942",
            "telephone_number": "253-845-4655",
            "fax_number": "253-845-1052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5511 112TH AVENUE CT E",
            "address_2": "SUITE B",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983725942",
            "telephone_number": "253-845-4655",
            "fax_number": "253-845-1052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SILLITO CHIROPRACTIC CENTER, PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SILLITO",
        "authorized_official_first_name": "DERROL",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "253-845-4655",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "1192",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Puyallup, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.