NPIMap

Organization Active NPI

Petrilli Chiropractic Services PS

Doing business as Chiropractic Healthcare

  • Chiropractor
  • Renton, WA
National Provider Identifier
1467678037
Registry record updated Dec 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
PETRILLI CHIROPRACTIC SERVICES PS
Doing business as
Chiropractic Healthcare
Practice address
11014 SE 192ND St
Renton, WA 98055-7432
Phone
(253) 852-8640
Fax
(253) 854-2690
NPI assigned
Apr 18, 2007
Last updated
Dec 15, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2014

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

Authorized official

Name
Dr. Brett J Petrilli, D.C.NPI 1114143237
Title
President
Phone
(253) 852-8640

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X NU Primary
Massage Therapist 225700000X NU

Addresses

Primary practice location

11014 SE 192ND St
Renton, WA 98055-7432

Mailing address

11014 SE 192ND St
Renton, WA 98055-7432
Phone (253) 852-8640

Other identifiers 1

IdentifierTypeStateIssuer
43666OtherWAL&I GROUP NUMBER

Other names 1

  • Chiropractic Healthcare Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1176854400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1418601600000",
    "number": "1467678037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11014 SE 192ND ST",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980557432",
            "telephone_number": "253-852-8640",
            "fax_number": "253-854-2690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11014 SE 192ND ST",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980557432",
            "telephone_number": "253-852-8640",
            "fax_number": "253-854-2690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PETRILLI CHIROPRACTIC SERVICES PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-18",
        "last_updated": "2014-12-15",
        "status": "A",
        "authorized_official_last_name": "PETRILLI",
        "authorized_official_first_name": "BRETT",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "253-852-8640",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I GROUP NUMBER",
            "identifier": "43666",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Chiropractic Healthcare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Renton, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 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.