Individual provider Active NPI

Jean Marie Scarzello Wakeland, BS DC

  • Chiropractor
  • Fircrest, WA
National Provider Identifier
1568510972
Registry record updated May 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH00002249 Issued in WA
Practice address
6412 20TH Street Court West
Fircrest, WA 98466-6227
Phone
(253) 566-8800
Fax
(253) 566-7092
NPI assigned
Jan 8, 2007
Last updated
May 1, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 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 CH00002249 WA Primary

Addresses

Primary practice location

6412 20TH Street Court West
Fircrest, WA 98466-6227

Mailing address

6412 20TH Street Court West
Fircrest, WA 98466-6227
Phone (253) 566-8800

Other identifiers 1

IdentifierTypeStateIssuer
53872OtherLABOR & INDUSTRIES

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040409000146 WA Practitioner - Chiropractic 1850385279 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

6412 20TH St CT W
Fircrest, WA 98466-6227
Phone (253) 566-8800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Bachelor of Science

State licenses

LicenseStateTypeSpecialty
CH00002249WAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Wakeland Chiropractic Center Inc PS Chiropractor CurrentSince Feb 1, 2009 Accepting new patients
Creekside Chiropractic and Massage, PS Chiropractor CurrentSince Apr 30, 2012 Accepting new patients

Locations

6210 75th St W
Ste A100
Tacoma, WA 98499
Phone (253) 588-1800

6412 20th Street Ct W
Tacoma, WA 98466
Phone (253) 566-8800

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, 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": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209600000000",
    "number": "1568510972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6412 20TH STREET COURT WEST",
            "city": "FIRCREST",
            "state": "WA",
            "postal_code": "984666227",
            "telephone_number": "253-566-8800",
            "fax_number": "253-566-7092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6412 20TH STREET COURT WEST",
            "city": "FIRCREST",
            "state": "WA",
            "postal_code": "984666227",
            "telephone_number": "253-566-8800",
            "fax_number": "253-566-7092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCARZELLO WAKELAND",
        "first_name": "JEAN",
        "middle_name": "MARIE",
        "credential": "BS DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-08",
        "last_updated": "2008-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH00002249",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR & INDUSTRIES",
            "identifier": "53872",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fircrest, WA

Sources for this page

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