Individual provider Active NPI

Robert Lawrenson, DC

  • Chiropractor
  • Puyallup, WA
National Provider Identifier
1558419952
Registry record updated Aug 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH0003152 Issued in WA
Practice address
2711 E Main
Puyallup, WA 98372-3165
Phone
(253) 527-8888
NPI assigned
Jan 8, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH0003152 WA Primary

Addresses

Primary practice location

2711 E Main
Puyallup, WA 98372-3165

Mailing address

2711 E Main
Puyallup, WA 98372-3165
Phone (253) 527-8888

Other identifiers 2

IdentifierTypeStateIssuer
104610OtherWAL&I
LA6038OtherWAREGENCE ID#

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220615002186 WA Practitioner - Chiropractic 2264811603 Practice locations: Puyallup, WA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH0003152WAMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722816000000",
    "number": "1558419952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2711 E MAIN",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983723165",
            "telephone_number": "253-527-8888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2711 E MAIN",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983723165",
            "telephone_number": "253-527-8888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAWRENSON",
        "first_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-08",
        "last_updated": "2024-08-05",
        "certification_date": "2024-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH0003152",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I",
            "identifier": "104610",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE ID#",
            "identifier": "LA6038",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Puyallup, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.