NPIMap

Organization Active NPI

Functional Health Consulting, LLC

Doing business as Vida Integrated Health

  • Chiropractor
  • Renton, WA
National Provider Identifier
1598548877
Registry record updated Aug 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
FUNCTIONAL HEALTH CONSULTING, LLC
Doing business as
Vida Integrated Health
Practice address
2715 Sunset LN NE
Suite 106
Renton, WA 98056
Phone
(206) 726-9595
NPI assigned
Aug 18, 2023
Last updated
Aug 21, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
FUNCTIONAL HEALTH CONSULTING, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 21, 2023

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

Authorized official

Name
Debbie Troxler
Title
Credentialing Specialist
Phone
(425) 355-5222

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

2715 Sunset LN NE
Suite 106
Renton, WA 98056

Mailing address

15 SW Everett Mall Way Ste G
Everett, WA 98204-2715
Phone (425) 355-5222

Other names 1

  • Vida Integrated Health Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110124000928 WA Part B Supplier - Clinic/Group Practice 1759560709 Receives reassigned benefits from 41 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Seattle, WA; Renton, WA; Everett, WA; Bellevue, WA; Kirkland, WA

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Functional Health Consulting LLC4 organizations share this tax ID, including this one
Part of
Functional Health Consulting LLC

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

606 120th Ave NE
Ste D100
Bellevue, WA 98005
Phone (425) 688-0223

Practitioners & affiliated clinicians

Practitioners 55

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 55

NPI Registry JSON

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

{
    "created_epoch": "1692316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692576000000",
    "number": "1598548877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 SW EVERETT MALL WAY STE G",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982042715",
            "telephone_number": "425-355-5222",
            "fax_number": "425-355-5231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2715 SUNSET LN NE",
            "address_2": "SUITE 106",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "98056",
            "telephone_number": "206-726-9595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FUNCTIONAL HEALTH CONSULTING, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FUNCTIONAL HEALTH CONSULTING, LLC",
        "enumeration_date": "2023-08-18",
        "last_updated": "2023-08-21",
        "certification_date": "2023-08-18",
        "status": "A",
        "authorized_official_last_name": "TROXLER",
        "authorized_official_first_name": "DEBBIE",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "425-355-5222"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vida Integrated Health",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Vida Integrated Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Renton, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2023; 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.