Active NPI
Shaun Richard Reynolds, D.C.
- Chiropractor
- Seattle, WA
National Provider Identifier
1679507222
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- CH00033629
- Practice address
- 1100 NE 47TH St
101
Seattle, WA 98105-4686 - Phone
- (206) 527-0123
- Fax
- (206) 527-0133
- NPI assigned
- Jul 10, 2006
- Last updated
- Jul 9, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | CH00033629 | WA | Primary |
Addresses
Primary practice location
1100 NE 47TH St
101
Seattle, WA 98105-4686
Mailing address
1100 NE 47TH St
101
Seattle, WA 98105-4686
Phone (206) 527-0123
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Palmer College Chiropractic - West Sunnyvale, 1999
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
1100 NE 47TH St
Suite 101
Seattle, WA 98105-4685
1100 NE 47TH St
Suite 101
Seattle, WA 98105-4686
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CH00033629 | WA | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dech | Chiropractor | Current | Accepting new patients |
Locations
1100 NE 47th St
Ste 101
Seattle, WA 98105
Phone (206) 527-0123
Organizations & group practices 2
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152489600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1679507222",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1100 NE 47TH ST",
"address_2": "101",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981054686",
"telephone_number": "206-527-0123",
"fax_number": "206-527-0133"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1100 NE 47TH ST",
"address_2": "101",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981054686",
"telephone_number": "206-527-0123",
"fax_number": "206-527-0133"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REYNOLDS",
"first_name": "SHAUN",
"middle_name": "RICHARD",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-10",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "WA",
"license": "CH00033629",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Seattle, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.