Individual provider Active NPI

Calvin Gene Mulanax, D.C.

  • Sports Physician Chiropractor
  • Shoreline, WA
National Provider Identifier
1518035534
Registry record updated Nov 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Physician ChiropractorTaxonomy code 111NS0005X
License
CH00034853 Issued in WA
Practice address
20130 Ballinger Way NE Ste 360
Shoreline, WA 98155-1117
Phone
(206) 426-3970
NPI assigned
Nov 30, 2006
Last updated
Nov 15, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Physician Chiropractor 111NS0005X CH00034853 WA Primary

Addresses

Primary practice location

20130 Ballinger Way NE Ste 360
Shoreline, WA 98155-1117

Mailing address

20130 Ballinger Way NE
Shoreline, WA 98155-1117
Phone (206) 426-3970

Other practice location 1

2946 Eastlake Ave E
Seattle, WA 98102-3010
Phone (206) 324-8600

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081118000280 WA Practitioner - Chiropractic 3375578339 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

20130 Ballinger Way NE
Shoreline, WA 98155-1117
Phone (206) 426-3970

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH00034853WAMDSports Physician Chiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Calvin Mulanax DC Corp Sports Physician CurrentSince Nov 1, 2022 Accepting new patients
Alternative Health & Nutrition Past Accepting new patients
Chiropractic Wellness Centers at Capitol Hill PS Inc Past Accepting new patients

Locations

2722 Eastlake Ave E
Ste 360
Seattle, WA 98102
Phone (206) 324-8600

20130 Ballinger Way NE
Shoreline, WA 98155
Phone (206) 426-3970

20130 Ballinger Way NE
Ste 360
Shoreline, WA 98155
Phone (206) 426-3970

Organizations & group practices 4

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": "1164844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668470400000",
    "number": "1518035534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20130 BALLINGER WAY NE",
            "city": "SHORELINE",
            "state": "WA",
            "postal_code": "981551117",
            "telephone_number": "206-426-3970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20130 BALLINGER WAY NE STE 360",
            "city": "SHORELINE",
            "state": "WA",
            "postal_code": "981551117",
            "telephone_number": "206-426-3970"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2946 Eastlake Ave E",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981023010",
            "country_code": "US",
            "telephone_number": "206-324-8600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MULANAX",
        "first_name": "CALVIN",
        "middle_name": "GENE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-30",
        "last_updated": "2022-11-15",
        "certification_date": "2022-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "WA",
            "license": "CH00034853",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shoreline, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 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.