Organization Active NPI

Emde Chiropractic PS

  • Chiropractor
  • Mount Vernon, WA
National Provider Identifier
1619247293
Registry record updated Jan 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2678 Issued in WA
Legal business name
EMDE CHIROPRACTIC PS
Practice address
2017 Continental PL
Suite 1
Mount Vernon, WA 98273-5649
Phone
(360) 424-3900
Fax
(360) 424-3900
NPI assigned
Jan 12, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2012

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

Authorized official

Name
Dr. John W Emde, DCNPI 1457427254
Title
President
Phone
(360) 424-3900

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 2678 WA Primary

Addresses

Primary practice location

2017 Continental PL
Suite 1
Mount Vernon, WA 98273-5649

Mailing address

2017 Continental PL
Suite 1
Mount Vernon, WA 98273-5649
Phone (360) 424-3900

Other identifiers 2

IdentifierTypeStateIssuer
34896OtherWALABOR & INDUSTRIES
EM8970OtherWABLUE CROSS BLUE SHILD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120203000362 WA Part B Supplier - Clinic/Group Practice 1658538517 Receives reassigned benefits from 1 practitioner
Practice locations: Mount Vernon, WA

National Provider Directory

National Provider Directory

Locations

2017 Continental Pl
Ste 1
Mount Vernon, WA 98273
Phone (360) 424-3900

Practitioners & affiliated clinicians

Practitioners 2

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": "1326326400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1326326400000",
    "number": "1619247293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2017 CONTINENTAL PL",
            "address_2": "SUITE 1",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982735649",
            "telephone_number": "360-424-3900",
            "fax_number": "360-424-3900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2017 CONTINENTAL PL",
            "address_2": "SUITE 1",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982735649",
            "telephone_number": "360-424-3900",
            "fax_number": "360-424-3900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMDE CHIROPRACTIC PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-12",
        "last_updated": "2012-01-12",
        "status": "A",
        "authorized_official_last_name": "EMDE",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "360-424-3900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "2678",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR & INDUSTRIES",
            "identifier": "34896",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHILD",
            "identifier": "EM8970",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Vernon, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2012; 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.