NPIMap

Organization Active NPI

Ocean Beach Chiropractic

  • Chiropractor
  • Ilwaco, WA
National Provider Identifier
1609074863
Registry record updated Aug 2, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH00034693 Issued in WA
Legal business name
OCEAN BEACH CHIROPRACTIC
Practice address
167 First Avenue, North
Ilwaco, WA 98624
Phone
(360) 642-2474
Fax
(360) 342-2363
NPI assigned
Jul 10, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2007

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

Authorized official

Name
Dr. Matthew James Reilly, D.C.
Title
Doctor
Phone
(360) 642-2474

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X CH00034693 WA Primary

Addresses

Primary practice location

167 First Avenue, North
Ilwaco, WA 98624

Mailing address

PO Box 186
167 First Avenue, North
Ilwaco, WA 98624-0186

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1184025600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1186012800000",
    "number": "1609074863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 186",
            "address_2": "167 FIRST AVENUE, NORTH",
            "city": "ILWACO",
            "state": "WA",
            "postal_code": "986240186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "167 FIRST AVENUE, NORTH",
            "city": "ILWACO",
            "state": "WA",
            "postal_code": "98624",
            "telephone_number": "360-642-2474",
            "fax_number": "360-342-2363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OCEAN BEACH CHIROPRACTIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-10",
        "last_updated": "2007-08-02",
        "status": "A",
        "authorized_official_last_name": "REILLY",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "360-642-2474",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH00034693",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ilwaco, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 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.

Verify at the official NPI Registry.