Individual provider Active NPI

Rodney O Dorland, D.C.

  • Chiropractor
  • Everett, WA
National Provider Identifier
1487868469
Registry record updated Feb 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH00001592 Issued in WA
Practice address
713 SE Everett Mall Way Ste B
Everett, WA 98208-3734
Phone
(425) 337-5588
Fax
(425) 355-2138
NPI assigned
May 9, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH00001592 WA Primary

Addresses

Primary practice location

713 SE Everett Mall Way Ste B
Everett, WA 98208-3734

Mailing address

713 SE Everett Mall Way Ste B
Everett, WA 98208-3734
Phone (425) 337-5588

Other identifiers 1

IdentifierTypeStateIssuer
2090702MedicaidWA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110228000798 WA Practitioner - Chiropractic 0941481667 Practice locations: Everett, WA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1178668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1298851200000",
    "number": "1487868469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "713 SE EVERETT MALL WAY STE B",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982083734",
            "telephone_number": "425-337-5588",
            "fax_number": "425-355-2138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "713 SE EVERETT MALL WAY STE B",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982083734",
            "telephone_number": "425-337-5588",
            "fax_number": "425-355-2138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DORLAND",
        "first_name": "RODNEY",
        "middle_name": "O",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-09",
        "last_updated": "2011-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH00001592",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2090702",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Everett, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2011; 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.