Genesis Chiropractic Center Inc PS

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CH00003092 Issued in WA

Legal business name

GENESIS CHIROPRACTIC CENTER INC PS

Practice address

5630 3Rd St
Ferndale, WA 98248

Phone

(360) 380-4848

NPI assigned

Sep 25, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Mark Alexander Mielke, DCNPI 1659410454

Title

President

Phone

(360) 380-4848

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mark Alexander Mielke, D.C.

  • Chiropractor
  • Ferndale, WA
  • NPI 1659410454
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1190678400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1195776000000",
    "number": "1508053497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2098",
            "city": "FERNDALE",
            "state": "WA",
            "postal_code": "982482098",
            "telephone_number": "360-380-4848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5630 3RD ST",
            "city": "FERNDALE",
            "state": "WA",
            "postal_code": "98248",
            "telephone_number": "360-380-4848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENESIS CHIROPRACTIC CENTER INC PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-25",
        "last_updated": "2007-11-23",
        "status": "A",
        "authorized_official_last_name": "MIELKE",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "ALEXANDER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "360-380-4848",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH00003092",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer J Gagnon, LMP
• Anthony Allen Gardiner, D.D.S.
• Melissa Garding
• Matthew Garza
• Meghan K Gattis, LMT
• Joshpal Singh Gill, OD
• Michael Alexander Glen, R.PH.
• Leigh Gongaware, OD
• Megan Good, LMT
• Andrew Gordon Goss, ATC

• Chiropractor in Ferndale, WA
• Providers in Ferndale, WA by specialty
• Chiropractor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2007; 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.