Active NPI
Jennifer Anne Wilson, D.C.
- Chiropractor
- Everett, WA
National Provider Identifier
1568520849
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- CH00033773
- Practice address
- 2824 Grand Ave Ste 102
Everett, WA 98201-3482 - Phone
- (425) 257-0177
- Fax
- (425) 257-1088
- NPI assigned
- Dec 5, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | CH00033773 | WA | Primary |
Addresses
Primary practice location
2824 Grand Ave Ste 102
Everett, WA 98201-3482
Mailing address
2824 Grand Ave Ste 102
Everett, WA 98201-3482
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CH00033773 | WA | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Vitality Corporation | Chiropractor | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Chiropractor
- Everett, WA
- NPI 1770148363
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165276800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1568520849",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2824 GRAND AVE STE 102",
"city": "EVERETT",
"state": "WA",
"postal_code": "982013482",
"fax_number": "425-257-1088"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2824 GRAND AVE STE 102",
"city": "EVERETT",
"state": "WA",
"postal_code": "982013482",
"telephone_number": "425-257-0177",
"fax_number": "425-257-1088"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "JENNIFER",
"middle_name": "ANNE",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-05",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "WA",
"license": "CH00033773",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Everett, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.