Organization Active NPI

Chiro One Wellness Center of Salmon Creek, PLLC

  • Chiropractor
  • Vancouver, WA
National Provider Identifier
1669007613
Registry record updated Mar 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
CHIRO ONE WELLNESS CENTER OF SALMON CREEK, PLLC
Practice address
13800 NE 20TH Ave
Vancouver, WA 98686-2704
Phone
(360) 574-5944
NPI assigned
Mar 10, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2020

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

Authorized official

Name
Amy Moran
Title
Credentialing Manager
Phone
(630) 229-4430

Specialties & licenses 1

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

Addresses

Primary practice location

13800 NE 20TH Ave
Vancouver, WA 98686-2704

Mailing address

2625 Butterfield Rd Ste 301N
Oak Brook, IL 60523-1266
Phone (630) 468-1824

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200605001426 WA Part B Supplier - Clinic/Group Practice 3870914401 Receives reassigned benefits from 1 practitioner
Practice locations: Vancouver, WA

National Provider Directory

National Provider Directory

Locations

13800 NE 20th Ave
Vancouver, WA 98686
Phone (360) 574-5944

Practitioners & affiliated clinicians

Practitioners 4

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": "1583798400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1583798400000",
    "number": "1669007613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2625 BUTTERFIELD RD STE 301N",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231266",
            "telephone_number": "630-468-1824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13800 NE 20TH AVE",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986862704",
            "telephone_number": "360-574-5944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHIRO ONE WELLNESS CENTER OF SALMON CREEK, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-10",
        "last_updated": "2020-03-10",
        "certification_date": "2020-03-10",
        "status": "A",
        "authorized_official_last_name": "MORAN",
        "authorized_official_first_name": "AMY",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "630-229-4430"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2020; 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.