NPIMap

Organization Active NPI

Shelton Chiropractic and Wellness LLC

  • Chiropractor
  • Shelton, WA
National Provider Identifier
1497438857
Registry record updated Aug 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
SHELTON CHIROPRACTIC AND WELLNESS LLC
Practice address
1635 Olympic Hwy N
Shelton, WA 98584-3065
Phone
(360) 426-8060
NPI assigned
Aug 10, 2023
Last updated
Aug 10, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2023

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

Authorized official

Name
Dr. Ryan Macedo, DCNPI 1083949887
Title
Owner
Phone
(503) 544-1449

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X Primary
Sports Physician ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111NS0005X

Addresses

Primary practice location

1635 Olympic Hwy N
Shelton, WA 98584-3065

Mailing address

1635 Olympic Hwy N
Shelton, WA 98584-3065
Phone (360) 426-8060

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240126002211 WA Part B Supplier - Clinic/Group Practice 1759734635 Receives reassigned benefits from 5 practitioners
Practice locations: Shelton, WA

National Provider Directory

National Provider Directory

Locations

1635 Olympic Hwy N
Ste 100
Shelton, WA 98584
Phone (360) 426-8060

Practitioners & affiliated clinicians

Practitioners 18

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.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1691625600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691625600000",
    "number": "1497438857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1635 OLYMPIC HWY N",
            "city": "SHELTON",
            "state": "WA",
            "postal_code": "985843065",
            "telephone_number": "360-426-8060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1635 OLYMPIC HWY N",
            "city": "SHELTON",
            "state": "WA",
            "postal_code": "985843065",
            "telephone_number": "360-426-8060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHELTON CHIROPRACTIC AND WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-10",
        "last_updated": "2023-08-10",
        "certification_date": "2023-08-10",
        "status": "A",
        "authorized_official_last_name": "MACEDO",
        "authorized_official_first_name": "RYAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-544-1449",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "111NS0005X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor, Sports Physician",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelton, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2023; 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.