Individual provider Active NPI

Morgan Ruddiman

  • Chiropractor
  • Vancouver, WA
National Provider Identifier
1467803106
Registry record updated Jun 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH60642112 Issued in WA
Practice address
13712 NE 20TH Ave
Suite a
Vancouver, WA 98686-2698
Phone
(360) 574-5944
Fax
(360) 574-6430
NPI assigned
Jun 23, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH60642112 WA Primary

Addresses

Primary practice location

13712 NE 20TH Ave
Suite a
Vancouver, WA 98686-2698

Mailing address

13712 NE 20TH Ave
Suite a
Vancouver, WA 98686-2698
Phone (360) 574-5944

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160719000653 WA Practitioner - Chiropractic 1850684507 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College - West, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2210 W Main St
Suite 101
Battle Ground, WA 98604-4232
Phone (360) 369-5150

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH60642112WAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Chiro One Wellness Center of Salmon Creek, PLLC Chiropractor CurrentSince May 1, 2020 Accepting new patients
Battle Ground Advantage Chiropractic PS Chiropractor CurrentSince Jun 27, 2024 Accepting new patients

Locations

2210 W Main St
Ste 101
Battle Ground, WA 98604
Phone (360) 369-5150

13800 NE 20th Ave
Vancouver, WA 98686
Phone (360) 574-5944

Organizations & group practices 2

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": "1466640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466640000000",
    "number": "1467803106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13712 NE 20TH AVE",
            "address_2": "SUITE A",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986862698",
            "telephone_number": "360-574-5944",
            "fax_number": "360-574-6430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13712 NE 20TH AVE",
            "address_2": "SUITE A",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986862698",
            "telephone_number": "360-574-5944",
            "fax_number": "360-574-6430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUDDIMAN",
        "first_name": "MORGAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-23",
        "last_updated": "2016-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH60642112",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2016; 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.