Individual provider Active NPI

Ryan Sean Coogan, D.C.

  • Chiropractor
  • Kirkland, WA
National Provider Identifier
1669522504
Registry record updated Mar 12, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH00034000 Issued in WA
Practice address
11902 97TH Ave NE
Kirkland, WA 98034-1882
Phone
(425) 821-4600
Fax
(425) 821-4622
NPI assigned
Jan 11, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH00034000 WA Primary

Addresses

Primary practice location

11902 97TH Ave NE
Kirkland, WA 98034-1882

Mailing address

11902 97TH Ave NE
Kirkland, WA 98034-1882
Phone (425) 821-4600

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040204000223 WA Practitioner - Chiropractic 6800789876 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College - West, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ryan Coogan DC PSGroup PAC ID 9931119922, 2 clinicians

Practice addresses (Care Compare)

11902 97TH Ave NE
Kirkland, WA 98034-1882
Phone (425) 821-4600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH00034000WAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Ryan Coogan DC PS Chiropractor CurrentSince Apr 20, 2004 Accepting new patients

Locations

11902 97th Ave NE
Kirkland, WA 98034
Phone (425) 821-4600

14709 Aurora Ave N
Shoreline, WA 98133
Phone (206) 363-4478

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1168473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1236816000000",
    "number": "1669522504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11902 97TH AVE NE",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980341882",
            "telephone_number": "425-821-4600",
            "fax_number": "425-821-4622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11902 97TH AVE NE",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980341882",
            "telephone_number": "425-821-4600",
            "fax_number": "425-821-4622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOGAN",
        "first_name": "RYAN",
        "middle_name": "SEAN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-11",
        "last_updated": "2009-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH00034000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kirkland, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2009; 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.

Verify at the official NPI Registry.