Active NPI
Taylor Jacob Vanquaethem, D.C.
- Chiropractor
- Olympia, WA
National Provider Identifier
1508159070
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- CH60225617
- 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, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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 ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| CH60225617 | WA | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New 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.
-
- Chiropractor
- Olympia, WA
- NPI 1629267471
-
- Chiropractor
- Olympia, WA
- NPI 1962898932
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.