Individual provider Active NPI

Staten C Medsker Jr., D.C.

  • Chiropractor
  • Bellevue, WA
National Provider Identifier
1639222433
Registry record updated Dec 26, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2119 Issued in TN
Practice address
15600 NE 8TH St
B1-468
Bellevue, WA 98008-3927
Phone
(423) 284-1441
NPI assigned
Jan 18, 2007
Last updated
Dec 26, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 26, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2119 TN Primary

Addresses

Primary practice location

15600 NE 8TH St
B1-468
Bellevue, WA 98008-3927

Mailing address

15600 NE 8TH St
B1-468
Bellevue, WA 98008-3927
Phone (423) 284-1441

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
Total Health PLLC Chiropractor PastSince May 8, 2013 Accepting new patients
Mobile Chiropractic & Massage, PLLC 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, 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": "1169078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1419552000000",
    "number": "1639222433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15600 NE 8TH ST",
            "address_2": "B1-468",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980083927",
            "telephone_number": "423-284-1441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15600 NE 8TH ST",
            "address_2": "B1-468",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980083927",
            "telephone_number": "423-284-1441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDSKER",
        "first_name": "STATEN",
        "middle_name": "C",
        "name_suffix": "Jr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-18",
        "last_updated": "2014-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TN",
            "license": "2119",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2014; 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.