NPIMap

Organization Active NPI

Valley Chiropractic and Wellness, PLLC

  • Chiropractor
  • Mount Vernon, WA
National Provider Identifier
1487045332
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH00001908 Issued in WA
Legal business name
VALLEY CHIROPRACTIC AND WELLNESS, PLLC
Practice address
1420 Roosevelt Ave Ste 7
Mount Vernon, WA 98273-2687
Phone
(360) 941-0505
NPI assigned
Feb 13, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Dr. Lori Delight Johnson, D.C.NPI 1841296803
Title
Owner/Doctor of Chiropractic
Phone
(360) 941-0505

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 CH00001908 WA Primary

Addresses

Primary practice location

1420 Roosevelt Ave Ste 7
Mount Vernon, WA 98273-2687

Mailing address

1420 Roosevelt Ave Ste 7
Mount Vernon, WA 98273-2687
Phone (360) 941-0505

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150506000398 WA Part B Supplier - Clinic/Group Practice 8729307152 Receives reassigned benefits from 4 practitioners
Practice locations: Mount Vernon, WA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

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": "1423785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1487045332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1420 ROOSEVELT AVE STE 7",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982732687",
            "telephone_number": "360-941-0505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1420 ROOSEVELT AVE STE 7",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982732687",
            "telephone_number": "360-941-0505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VALLEY CHIROPRACTIC AND WELLNESS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-13",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "LORI",
        "authorized_official_middle_name": "DELIGHT",
        "authorized_official_title_or_position": "OWNER/DOCTOR OF CHIROPRACTIC",
        "authorized_official_telephone_number": "360-941-0505",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH00001908",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Vernon, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.