NPIMap

Organization Active NPI

Lynnwood Family Chiropractic PS

  • Chiropractor
  • Lynnwood, WA
National Provider Identifier
1477698553
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH00034211 Issued in WA
Legal business name
LYNNWOOD FAMILY CHIROPRACTIC PS
Practice address
16303 Highway 99
Suite 1B
Lynnwood, WA 98087-1453
Phone
(425) 743-9460
Fax
(425) 367-4404
NPI assigned
Feb 20, 2007
Last updated
Aug 22, 2020By the provider in NPPES
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
Dr. John J Sim, DCNPI 1699872093
Title
Owner
Phone
(425) 743-9460

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
Chiropractor 111N00000X CH00034211 WA Primary

Addresses

Primary practice location

16303 Highway 99
Suite 1B
Lynnwood, WA 98087-1453

Mailing address

16303 Highway 99
Suite 1B
Lynnwood, WA 98087-1453
Phone (425) 743-9460

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070131000737 WA Part B Supplier - Clinic/Group Practice 5698777811 Receives reassigned benefits from 1 practitioner
Practice locations: Lynnwood, WA

National Provider Directory

National Provider Directory
Tax ID family
Lynnwood Family Chiropractic2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 7

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": "1171929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1477698553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16303 HIGHWAY 99",
            "address_2": "SUITE 1B",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980871453",
            "telephone_number": "425-743-9460",
            "fax_number": "425-367-4404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16303 HIGHWAY 99",
            "address_2": "SUITE 1B",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980871453",
            "telephone_number": "425-743-9460",
            "fax_number": "425-367-4404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LYNNWOOD FAMILY CHIROPRACTIC PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SIM",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "425-743-9460",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH00034211",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynnwood, 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.