Active NPI
Kevin Douglas Shearer, D.C.
- Chiropractor
- Vancouver, WA
National Provider Identifier
1669421376
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- CH00034737
- Practice address
- 17720 SE Mill Plain Blvd
Suite 160
Vancouver, WA 98683-7583 - Phone
- (360) 944-4437
- NPI assigned
- May 9, 2006
- Last updated
- Oct 22, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | KS8927 | MI | |
| Chiropractor | 111N00000X | CH00034737 | WA | Primary |
Addresses
Primary practice location
17720 SE Mill Plain Blvd
Suite 160
Vancouver, WA 98683-7583
Mailing address
17720 SE Mill Plain Blvd
Suite 160
Vancouver, WA 98683-7583
Phone (360) 944-4437
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 95-0-C3-1317-0 | Other | MI | BCBS |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| KS8927 | MI | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Thomas W Moses DC PC | Chiropractor | Past | Accepting new patients |
| Infinity Chiropractic Center P L L C | Chiropractor | Past | Accepting new patients |
| Holdahl Chiropractic PLLC | Past | Accepting new patients |
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.
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- Dearborn, MI
- NPI 1518077973
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147132800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1350864000000",
"number": "1669421376",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17720 SE MILL PLAIN BLVD",
"address_2": "SUITE 160",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "986837583",
"telephone_number": "360-944-4437"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17720 SE MILL PLAIN BLVD",
"address_2": "SUITE 160",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "986837583",
"telephone_number": "360-944-4437"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHEARER",
"first_name": "KEVIN",
"middle_name": "DOUGLAS",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-09",
"last_updated": "2012-10-22",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "MI",
"license": "KS8927",
"primary": false
},
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "WA",
"license": "CH00034737",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "95-0-C3-1317-0",
"state": "MI"
}
],
"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 Oct 22, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.