Samuel Wardell

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CH61003550 Issued in WA

Practice address

10614 Canyon Rd E
Puyallup, WA 98373-4257

Phone

(253) 535-6006

Fax

(253) 535-6226

NPI assigned

Oct 11, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Specialty

Chiropractic

Education

Life Chiropractic College - West, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Rody Chiropractic Clinic IncGroup PAC ID 5890787543, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Rody Chiropractic Clinic Inc.

  • Chiropractor
  • Puyallup, WA
  • NPI 1255500351
  Medicare reassignment Care Compare group NPD
• Rody Chiropractic LLC

  • Massage Therapist
  • Puyallup, WA
  • NPI 1063705317
  NPD (past)

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

{
    "created_epoch": "1570752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570752000000",
    "number": "1609418565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10614 CANYON RD E",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983734257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10614 CANYON RD E",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983734257",
            "telephone_number": "253-535-6006",
            "fax_number": "253-535-6226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARDELL",
        "first_name": "SAMUEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-10-11",
        "last_updated": "2019-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH61003550",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathy I-Wen Wang, DO
• Zhuowei Wang, MD
• Peter Mwaura Wanyoike
• David B Ward, PH.D.
• Laetitia Ward, PH.D.
• Balynda Gayle Warden
• Theresa Marie Wardle, RN
• Ricardo Ware
• Kurt Joseph Warkenthien, M.D.
• Debbi Warner Reed

• Chiropractor in Puyallup, WA
• Providers in Puyallup, WA by specialty
• Chiropractor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2019; 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.