Individual provider Active NPI

Cathy Ann Bangerter, D.C.

  • Orthopedic Chiropractor
  • Bothell, WA
National Provider Identifier
1508923277
Registry record updated Apr 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic ChiropractorTaxonomy code 111NX0800X
License
CH00002308 Issued in WA
Practice address
10116 Main St Ste B2
Bothell, WA 98011-3449
Phone
(425) 485-1464
NPI assigned
Jan 2, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 5, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Chiropractor 111NX0800X CH00002308 WA Primary

Addresses

Primary practice location

10116 Main St Ste B2
Bothell, WA 98011-3449

Mailing address

10116 Main St Ste B2
Bothell, WA 98011-3449
Phone (425) 485-1464

Other identifiers 3

IdentifierTypeStateIssuer
69092OtherWAL & I
BA5407OtherWAREGENCE NUMBER
2030039MedicaidWA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110512000068 WA Practitioner - Chiropractic 2365628179 Practice locations: Bothell, WA

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Western States College of Chiropractic, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

10116 Main St
Bothell, WA 98011-3449
Phone (425) 485-1464

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH00002308WAMDOrthopedic Chiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Health in Action Chiropractic CurrentSince Apr 10, 2022 Accepting new patients

Locations

10116 Main St
Ste B2
Bothell, WA 98011
Phone (425) 485-1464

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": "1167696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649116800000",
    "number": "1508923277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10116 MAIN ST STE B2",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980113449",
            "telephone_number": "425-485-1464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10116 MAIN ST STE B2",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980113449",
            "telephone_number": "425-485-1464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANGERTER",
        "first_name": "CATHY",
        "middle_name": "ANN",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-02",
        "last_updated": "2022-04-05",
        "certification_date": "2022-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NX0800X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Orthopedic",
            "state": "WA",
            "license": "CH00002308",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L & I",
            "identifier": "69092",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE NUMBER",
            "identifier": "BA5407",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2030039",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bothell, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2022; 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.