Individual provider Active NPI

Randy R Zolman, D.C.

  • Chiropractor
  • Quincy, WA
National Provider Identifier
1629007935
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH00002703 Issued in WA
Practice address
210 G St SE
Quincy, WA 98848-1556
Phone
(509) 787-1918
NPI assigned
Jun 30, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH00002703 WA Primary

Addresses

Primary practice location

210 G St SE
Quincy, WA 98848-1556

Mailing address

210 G St SE
Quincy, WA 98848-1556
Phone (509) 787-1918

Other identifiers 1

IdentifierTypeStateIssuer
304703MedicaidWA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080611000094 WA Practitioner - Chiropractic 5294806790 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 1992
Medicare assignment
May accept Medicare assignment
Group practices
Mt Stuart PT PSGroup PAC ID 9335133016, 4 clinicians
Iroc PSGroup PAC ID 1557434768, 3 clinicians

Practice addresses (Care Compare)

10171 Chumstick Hwy
Suite 1
Leavenworth, WA 98826-8762
Phone (509) 548-3133

603 N Mission St
Wenatchee, WA 98801-2049
Phone (509) 884-4357

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH00002703WAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Iroc PS Chiropractor CurrentSince Aug 28, 2023 Accepting new patients
Mt. Stuart P.T., P.S. CurrentSince Apr 16, 2023 Accepting new patients
Zolman Chiropractic Clinic PLLC Chiropractor CurrentSince Jun 11, 2008 Accepting new patients
E & H Holdings, LLC Past Accepting new patients

Locations

10171 Chumstick Hwy
Ste 1
Leavenworth, WA 98826
Phone (509) 548-3133

110 C St SW
Quincy, WA 98848
Phone (509) 787-1918

210 G St SE
Quincy, WA 98848
Phone (509) 787-1918

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Quincy Valley Medical CenterQuincy, WA, CCN 503976 Rural health clinic Corporate Director Jan 1, 2010

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1629007935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 G ST SE",
            "city": "QUINCY",
            "state": "WA",
            "postal_code": "988481556",
            "telephone_number": "509-787-1918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 G ST SE",
            "city": "QUINCY",
            "state": "WA",
            "postal_code": "988481556",
            "telephone_number": "509-787-1918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZOLMAN",
        "first_name": "RANDY",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH00002703",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "304703",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Quincy, WA

Sources for this page

Verify at the official NPI Registry.