Individual provider Active NPI

Jeffrey S Martin, DC

  • Chiropractor
  • Moses Lake, WA
National Provider Identifier
1629602123
Registry record updated Mar 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH61028883 Issued in WA
Practice address
420 W 3Rd Ave
Moses Lake, WA 98837-1908
Phone
(509) 765-0638
Fax
(509) 765-3891
NPI assigned
Feb 24, 2020
Last updated
Mar 4, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH61028883 WA Primary

Addresses

Primary practice location

420 W 3Rd Ave
Moses Lake, WA 98837-1908

Mailing address

PO Box 1415
Moses Lake, WA 98837-0217
Phone (509) 765-0638

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

Practice roles

OrganizationSpecialtyStatusNew patients
Gregg M Jones Chiropractor CurrentSince Jul 5, 2020 Accepting new patients
Healthsource of Moses Lake PastSince Feb 4, 2020 Accepting new patients
TRSR, PLLC Chiropractor PastSince Aug 1, 2021 Accepting new patients

Locations

420 W 3rd Ave
Moses Lake, WA 98837
Phone (509) 765-0638

Organizations & group practices 3

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": "1582502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583280000000",
    "number": "1629602123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1415",
            "city": "MOSES LAKE",
            "state": "WA",
            "postal_code": "988370217",
            "telephone_number": "509-765-0638",
            "fax_number": "509-765-3891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 W 3RD AVE",
            "city": "MOSES LAKE",
            "state": "WA",
            "postal_code": "988371908",
            "telephone_number": "509-765-0638",
            "fax_number": "509-765-3891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "JEFFREY",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-02-24",
        "last_updated": "2020-03-04",
        "certification_date": "2020-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH61028883",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moses Lake, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2020; 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.