NPIMap

Organization Active NPI

Proctor Chiropractic Inc. PS

Doing business as Proctor Chiropractic

  • Chiropractor
  • Tacoma, WA
National Provider Identifier
1669517553
Registry record updated Jun 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH00033867 Issued in WA
Legal business name
PROCTOR CHIROPRACTIC INC. PS
Doing business as
Proctor Chiropractic
Practice address
3901 6TH Ave
Tacoma, WA 98406-4940
Phone
(253) 756-7500
Fax
(253) 756-7501
NPI assigned
Feb 20, 2007
Last updated
Jun 18, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2019

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

Authorized official

Name
Dr. George Peter Keogh, D.C.NPI 1619047685
Title
Owner Chiropractor
Phone
(253) 756-7500

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH00033867 WA Primary

Addresses

Primary practice location

3901 6TH Ave
Tacoma, WA 98406-4940

Mailing address

3901 6TH Ave
Tacoma, WA 98406-4940
Phone (253) 756-7500

Other names 1

  • Proctor Chiropractic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070926001070 WA Part B Supplier - Clinic/Group Practice 7618062365 Receives reassigned benefits from 3 practitioners
Practice locations: Tacoma, WA

National Provider Directory

National Provider Directory

Locations

2520 N Proctor St
Tacoma, WA 98406
Phone (253) 756-7500

3901 6th Ave
Tacoma, WA 98406
Phone (253) 756-7500

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560816000000",
    "number": "1669517553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3901 6TH AVE",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984064940",
            "telephone_number": "253-756-7500",
            "fax_number": "253-756-7501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3901 6TH AVE",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984064940",
            "telephone_number": "253-756-7500",
            "fax_number": "253-756-7501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROCTOR CHIROPRACTIC INC. PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-20",
        "last_updated": "2019-06-18",
        "status": "A",
        "authorized_official_last_name": "KEOGH",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "PETER",
        "authorized_official_title_or_position": "OWNER CHIROPRACTOR",
        "authorized_official_telephone_number": "253-756-7500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH00033867",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Proctor Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Proctor Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tacoma, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2019; 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.