Individual provider Active NPI

Taylor Jacob Vanquaethem, D.C.

  • Chiropractor
  • Olympia, WA
National Provider Identifier
1508159070
Registry record updated May 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH60225617 Issued in WA
Practice address
1645 Cooper Point Rd SW
Olympia, WA 98502-5735
Phone
(360) 943-6206
Fax
(360) 943-6276
NPI assigned
May 17, 2011
Last updated
May 17, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 17, 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 CH60225617 WA Primary

Addresses

Primary practice location

1645 Cooper Point Rd SW
Olympia, WA 98502-5735

Mailing address

PO Box 2291
Olympia, WA 98507-2291
Phone (360) 943-6206

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110927000738 WA Practitioner - Chiropractic 3678744422 Practice locations: Olympia, WA

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Sherman College of Straight Chiropractic, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4419 Harrison Ave NW
Suite 107
Olympia, WA 98502-5087
Phone (360) 789-5649

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH60225617WAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Langel Chiropractic, P.S. Chiropractor Past Accepting new patients
Vanquaethem Chiropractic Clinic Chiropractor Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1305590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1305590400000",
    "number": "1508159070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2291",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985072291",
            "telephone_number": "360-943-6206",
            "fax_number": "360-943-6276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1645 COOPER POINT RD SW",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985025735",
            "telephone_number": "360-943-6206",
            "fax_number": "360-943-6276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANQUAETHEM",
        "first_name": "TAYLOR",
        "middle_name": "JACOB",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-05-17",
        "last_updated": "2011-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH60225617",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Olympia, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 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.