Individual provider Active NPI

David W Chan, D.C.

  • Chiropractor
  • Kennewick, WA
National Provider Identifier
1609095835
Registry record updated Feb 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Practice address
4339 W Kennewick Ave
Kennewick, WA 99336-2802
Phone
(509) 735-0311
Fax
(509) 783-1206
NPI assigned
Apr 25, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 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 WA Primary

Addresses

Primary practice location

4339 W Kennewick Ave
Kennewick, WA 99336-2802

Mailing address

4339 W Kennewick Ave
Kennewick, WA 99336-2802
Phone (509) 735-0311

Other identifiers 1

IdentifierTypeStateIssuer
0116689OtherWADEPARTMENT OF L AND I

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

LicenseStateTypeSpecialty
CH000001534WAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Marsh Chiropractic, PS Chiropractor Past Accepting new patients
Petrilli Chiropractic Services PS Chiropractor Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1177459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203379200000",
    "number": "1609095835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4339 W KENNEWICK AVE",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993362802",
            "telephone_number": "509-735-0311",
            "fax_number": "509-783-1206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4339 W KENNEWICK AVE",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993362802",
            "telephone_number": "509-735-0311",
            "fax_number": "509-783-1206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAN",
        "first_name": "DAVID",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-25",
        "last_updated": "2008-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPARTMENT OF L AND I",
            "identifier": "0116689",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kennewick, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2008; 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.