Individual provider Active NPI

Paul Leslie Kendrick, DC

  • Orthopedic Chiropractor
  • Port Angeles, WA
National Provider Identifier
1669537718
Registry record updated Feb 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic ChiropractorTaxonomy code 111NX0800X
License
CH00002641 Issued in WA
Practice address
719 S Laurel St
Port Angeles, WA 98362-6020
Phone
(360) 457-8292
Fax
(360) 457-8274
NPI assigned
Dec 27, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 12, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Chiropractor 111NX0800X CH00002641 WA Primary

Addresses

Primary practice location

719 S Laurel St
Port Angeles, WA 98362-6020

Mailing address

719 S Laurel St
Port Angeles, WA 98362-6020
Phone (360) 457-8292

Other identifiers 1

IdentifierTypeStateIssuer
0049949OtherWALABOR & INDUSTRIES

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

LicenseStateTypeSpecialty
025202WAMDRehabilitation Chiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Schweyen Chiropractic, P.S. PastSince Aug 1, 2010 Accepting new patients

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": "1167177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202774400000",
    "number": "1669537718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "719 S LAUREL ST",
            "city": "PORT ANGELES",
            "state": "WA",
            "postal_code": "983626020",
            "telephone_number": "360-457-8292",
            "fax_number": "360-457-8274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "719 S LAUREL ST",
            "city": "PORT ANGELES",
            "state": "WA",
            "postal_code": "983626020",
            "telephone_number": "360-457-8292",
            "fax_number": "360-457-8274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENDRICK",
        "first_name": "PAUL",
        "middle_name": "LESLIE",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-27",
        "last_updated": "2008-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NX0800X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Orthopedic",
            "state": "WA",
            "license": "CH00002641",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR & INDUSTRIES",
            "identifier": "0049949",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Angeles, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.