Individual provider Active NPI

Jerry Stanley Johnstone II, D.C.

  • Chiropractor
  • Lake Stevens, WA
National Provider Identifier
1497943153
Registry record updated Apr 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH00003108 Issued in WA
Practice address
515 Sr 9 NE
Suite 105
Lake Stevens, WA 98258-8523
Phone
(425) 334-1874
Fax
(425) 334-3852
NPI assigned
Oct 9, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 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 CH00003108 WA Primary

Addresses

Primary practice location

515 Sr 9 NE
Suite 105
Lake Stevens, WA 98258-8523

Mailing address

515 Sr 9 NE
Suite 105
Lake Stevens, WA 98258-8523
Phone (425) 334-1874

Other names 1

  • Dr. Jeremy Stanley Johnstone Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110415000224 WA Practitioner - Chiropractic 2567455579 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - West Sunnyvale, 1995
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

515 Sr
9 Suite 105
Lake Stevens, WA 98258-8523
Phone (425) 334-1874

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
CH00003108WAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Johnstone Chiropractic Inc PS Chiropractor CurrentSince Feb 14, 2011 Accepting new patients

Locations

515 State Route 9 NE
Ste 105
Lake Stevens, WA 98258
Phone (425) 334-1874

Organizations & group practices 1

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": "1191888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1303344000000",
    "number": "1497943153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 SR 9 NE",
            "address_2": "SUITE 105",
            "city": "LAKE STEVENS",
            "state": "WA",
            "postal_code": "982588523",
            "telephone_number": "425-334-1874",
            "fax_number": "425-334-3852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 SR 9 NE",
            "address_2": "SUITE 105",
            "city": "LAKE STEVENS",
            "state": "WA",
            "postal_code": "982588523",
            "telephone_number": "425-334-1874",
            "fax_number": "425-334-3852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSTONE",
        "first_name": "JERRY",
        "middle_name": "STANLEY",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-10-09",
        "last_updated": "2011-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH00003108",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JEREMY",
            "last_name": "JOHNSTONE",
            "middle_name": "STANLEY",
            "prefix": "DR.",
            "credential": "D.C.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Lake Stevens, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2011; 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.