Individual provider Active NPI

Stephen John Chittenden, D.C.

  • Chiropractor
  • Lakewood, WA
National Provider Identifier
1487748372
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2148 Issued in WA
Practice address
8905 Gravelly Lake Dr SW
Lakewood, WA 98499-3109
Phone
(253) 581-1533
Fax
(253) 588-2145
NPI assigned
Oct 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2148 WA Primary

Addresses

Primary practice location

8905 Gravelly Lake Dr SW
Lakewood, WA 98499-3109

Mailing address

8905 Gravelly Lake Dr SW
Lakewood, WA 98499-3109
Phone (253) 581-1533

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110428000720 WA Practitioner - Chiropractic 5698950061 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Western States College of Chiropractic, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

8905 Gravelly Lake Dr SW
Lakewood, WA 98499-3109
Phone (253) 581-1533

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2148WAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Chittenden Chiropractic PS Chiropractor CurrentSince Nov 16, 2010 Accepting new patients
Dennis C. Sweet, D.C., P.S. Chiropractor PastSince Mar 16, 2011 Accepting new patients

Locations

8905 Gravelly Lake Dr SW
Tacoma, WA 98499
Phone (253) 581-1533

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": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1487748372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8905 GRAVELLY LAKE DR SW",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984993109",
            "telephone_number": "253-581-1533",
            "fax_number": "253-588-2145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8905 GRAVELLY LAKE DR SW",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984993109",
            "telephone_number": "253-581-1533",
            "fax_number": "253-588-2145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHITTENDEN",
        "first_name": "STEPHEN",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "2148",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.