Individual provider Active NPI

Kenneth Wayne Trapp, DC

  • Chiropractor
  • Lacey, WA
National Provider Identifier
1528024296
Registry record updated Jan 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH00002178 Issued in WA
Practice address
5600 Pacific Ave SE
Lacey, WA 98503-1258
Phone
(360) 493-2000
Fax
(360) 493-2437
NPI assigned
Apr 21, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 7, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH00002178 WA Primary

Addresses

Primary practice location

5600 Pacific Ave SE
Lacey, WA 98503-1258

Mailing address

5600 Pacific Ave SE
Lacey, WA 98503-1258
Phone (360) 493-2000

Other identifiers 2

IdentifierTypeStateIssuer
TR0129OtherWAREGENCE BLUE SHIELD
2010791MedicaidWA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070702000170 WA Practitioner - Chiropractic 8426157595 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Sherman College of Straight Chiropractic, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kenneth W Trapp DC IncGroup PAC ID 6901906585, 2 clinicians

Practice addresses (Care Compare)

5600 Pacific Ave SE
Lacey, WA 98503-1258
Phone (360) 493-2000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Kenneth W Trapp DC Inc Chiropractor CurrentSince Jul 11, 2007 Accepting new patients
Vert. Fitness & Wellness Center, LLC Chiropractor PastSince Aug 22, 2011 Accepting new patients

Locations

5600 Pacific Ave SE
Lacey, WA 98503
Phone (360) 493-2000

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1145577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1199664000000",
    "number": "1528024296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5600 PACIFIC AVE SE",
            "city": "LACEY",
            "state": "WA",
            "postal_code": "985031258",
            "telephone_number": "360-493-2000",
            "fax_number": "360-493-2437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5600 PACIFIC AVE SE",
            "city": "LACEY",
            "state": "WA",
            "postal_code": "985031258",
            "telephone_number": "360-493-2000",
            "fax_number": "360-493-2437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAPP",
        "first_name": "KENNETH",
        "middle_name": "WAYNE",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-21",
        "last_updated": "2008-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH00002178",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUE SHIELD",
            "identifier": "TR0129",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2010791",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lacey, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2008; 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.