Active NPI
Jeffrey Prause, DC
- Chiropractor
- Kennewick, WA
National Provider Identifier
1659937464
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 11090849-1202
- Practice address
- 512 N Young St Ste C
Kennewick, WA 99336-7839 - Phone
- (509) 736-2225
- NPI assigned
- May 16, 2019
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 11090849-1202 | UT | Primary |
Addresses
Primary practice location
512 N Young St Ste C
Kennewick, WA 99336-7839
Mailing address
512 N Young St Ste C
Kennewick, WA 99336-7839
Phone (509) 736-2225
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
512 N Young St
Suite C
Kennewick, WA 99336-7839
Phone (509) 736-2225
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11090849-1202 | UT | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| City of Kennewick | Current | Accepting new patients | |
| Jorgensen Prof Corp | Chiropractor | Current | Accepting new patients |
Locations
512 N Young St
Ste C
Kennewick, WA 99336
Phone (509) 572-2605
3603 W Court St
Pasco, WA 99301
Phone (509) 412-1085
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 and National Provider Directory roles.
-
- Chiropractor
- Kennewick, WA
- NPI 1346532835
-
- Ambulance
- Kennewick, WA
- NPI 1477548253
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1557964800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1560211200000",
"number": "1659937464",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "512 N YOUNG ST STE C",
"city": "KENNEWICK",
"state": "WA",
"postal_code": "993367839",
"telephone_number": "509-736-2225"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "512 N YOUNG ST STE C",
"city": "KENNEWICK",
"state": "WA",
"postal_code": "993367839",
"telephone_number": "509-736-2225"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PRAUSE",
"first_name": "JEFFREY",
"credential": "DC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-05-16",
"last_updated": "2019-06-11",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "UT",
"license": "11090849-1202",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Kennewick, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 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.