Individual provider Active NPI

Allen Nathanial Martin, D.C.

  • Chiropractor
  • Mount Vernon, WA
National Provider Identifier
1538210794
Registry record updated Aug 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH00034660 Issued in WA
Practice address
22790 Buchanan Street
Mount Vernon, WA 98273
Phone
(360) 856-5562
NPI assigned
Jan 15, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 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 CH00034660 WA Primary

Addresses

Primary practice location

22790 Buchanan Street
Mount Vernon, WA 98273

Mailing address

PO Box 508
Clearlake, WA 98235-0508
Phone (360) 856-5562

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070529000541 WA Practitioner - Chiropractic 6507963444 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Country Chiropractic Clinic PLLCGroup PAC ID 6709969447, 2 clinicians

Practice addresses (Care Compare)

22790 Buchanan St
Mount Vernon, WA 98273-8023
Phone (360) 856-5562

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH00034660WAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Country Chiropractic Clinic, PLLC Chiropractor CurrentSince Jan 1, 2008 Accepting new patients
North Sound Clinics, LLC PastSince Aug 17, 2018 Accepting new patients

Locations

22790 Buchanan St
Mount Vernon, WA 98273
Phone (360) 630-9943

Interoperability endpoints

  • Direct secure messaging: nathan@cccp0008.direct.chirotouch.md

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": "1168819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1217894400000",
    "number": "1538210794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 508",
            "city": "CLEARLAKE",
            "state": "WA",
            "postal_code": "982350508",
            "telephone_number": "360-856-5562",
            "fax_number": "360-856-4923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22790 BUCHANAN STREET",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "98273",
            "telephone_number": "360-856-5562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "ALLEN",
        "middle_name": "NATHANIAL",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-15",
        "last_updated": "2008-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH00034660",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Vernon, WA

Sources for this page

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