Individual provider Active NPI

Kelly Everett McCown, D.C.

  • Chiropractor
  • Longview, WA
National Provider Identifier
1548453905
Registry record updated Feb 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH00034799 Issued in WA
Practice address
755 Vandercook Way Ste 101a
Longview, WA 98632-4050
Phone
(360) 577-0294
Fax
(360) 577-2635
NPI assigned
Aug 20, 2007
Last updated
Feb 1, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 1, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH00034799 WA Primary

Addresses

Primary practice location

755 Vandercook Way Ste 101a
Longview, WA 98632-4050

Mailing address

755 Vandercook Way Ste 101a
Longview, WA 98632-4050
Phone (360) 577-0294

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071001000270 WA Practitioner - Chiropractic 0749375152 Practice locations: Longview, WA

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2007
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

755 Vandercook Way
Longview, WA 98632-4050
Phone (360) 577-0294

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1187568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454284800000",
    "number": "1548453905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "755 VANDERCOOK WAY STE 101A",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986324050",
            "telephone_number": "360-577-0294",
            "fax_number": "360-577-2635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "755 VANDERCOOK WAY STE 101A",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986324050",
            "telephone_number": "360-577-0294",
            "fax_number": "360-577-2635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCOWN",
        "first_name": "KELLY",
        "middle_name": "EVERETT",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-08-20",
        "last_updated": "2016-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH00034799",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Longview, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2016; 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.