Organization Active NPI

Kitsap Chiropractors PLLC

Doing business as Ryan Chiropractic Clinic / Delong Chiropractic Clinic

  • Chiropractor
  • Poulsbo, WA
National Provider Identifier
1477793677
Registry record updated Jan 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH3252 Issued in WA
Legal business name
KITSAP CHIROPRACTORS PLLC
Doing business as
Ryan Chiropractic Clinic / Delong Chiropractic Clinic
Practice address
19425 7TH Ave NE Ste 103
Poulsbo, WA 98370-5100
Phone
(360) 394-2000
Fax
(800) 403-8010
NPI assigned
Feb 27, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2020

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

Authorized official

Name
Dr. James Thomas Ryan, D.C.NPI 1255331344
Title
Member / Manager
Phone
(360) 394-2000

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: 193200000X MULTI-SPECIALTY GROUP 111N00000X CH3252 WA Primary

Addresses

Primary practice location

19425 7TH Ave NE Ste 103
Poulsbo, WA 98370-5100

Mailing address

PO Box 640
Poulsbo, WA 98370-0640
Phone (360) 394-2000

Other names 1

  • Ryan Chiropractic Clinic / Delong Chiropractic Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090423000049 WA Part B Supplier - Clinic/Group Practice 0749338143 Receives reassigned benefits from 1 practitioner
Practice locations: Poulsbo, WA

National Provider Directory

National Provider Directory

Locations

19220 8th Ave NE
#B
Poulsbo, WA 98370
Phone (360) 394-2000

19425 7th Ave NE
Ste 103
Poulsbo, WA 98370
Phone (360) 394-2000

Practitioners & affiliated clinicians

Practitioners 1

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": "1235692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1578960000000",
    "number": "1477793677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 640",
            "city": "POULSBO",
            "state": "WA",
            "postal_code": "983700640",
            "telephone_number": "360-394-2000",
            "fax_number": "800-403-8010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19425 7TH AVE NE STE 103",
            "city": "POULSBO",
            "state": "WA",
            "postal_code": "983705100",
            "telephone_number": "360-394-2000",
            "fax_number": "800-403-8010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KITSAP CHIROPRACTORS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-27",
        "last_updated": "2020-01-14",
        "certification_date": "2020-01-14",
        "status": "A",
        "authorized_official_last_name": "RYAN",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "THOMAS",
        "authorized_official_title_or_position": "MEMBER / MANAGER",
        "authorized_official_telephone_number": "360-394-2000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH3252",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ryan Chiropractic Clinic / Delong Chiropractic Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Poulsbo, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 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.