Individual provider Active NPI

Wayne Mark Latimer

  • Chiropractor
  • Wenatchee, WA
National Provider Identifier
1679615678
Registry record updated Apr 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH00003031 Issued in WA
Practice address
739 South Mission St.
Wenatchee, WA 98801
Phone
(509) 665-7208
NPI assigned
Feb 13, 2007
Last updated
Apr 27, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 27, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Physician Chiropractor 111NS0005X 3606 WA
Chiropractor 111N00000X CH00003031 WA Primary

Addresses

Primary practice location

739 South Mission St.
Wenatchee, WA 98801

Mailing address

603 N Mission St
Wenatchee, WA 98801-2049
Phone (509) 884-4357

Other identifiers 1

IdentifierTypeStateIssuer
0159778OtherWAWA ST. LABOR AND INDUSTRY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080513000083 WA Practitioner - Chiropractic 3971672270 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Western States College of Chiropractic, 1994
Medicare assignment
May accept Medicare assignment
Group practices
Mt Stuart PT PSGroup PAC ID 9335133016, 4 clinicians
Iroc PSGroup PAC ID 1557434768, 3 clinicians

Practice addresses (Care Compare)

10171 Chumstick Hwy
Suite 1
Leavenworth, WA 98826-8762
Phone (509) 548-3133

603 N Mission St
Wenatchee, WA 98801-2049
Phone (509) 884-4357

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH00003031WAMDChiropractor
3606WAMDSports Physician Chiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Iroc PS Chiropractor CurrentSince Feb 2, 2007 Accepting new patients
Mt. Stuart P.T., P.S. CurrentSince Aug 10, 2021 Accepting new patients
Gehm Chiropractic Services Past Accepting new patients
Hazel Dell Sports Medicine & Rehab Clinic PLLC Chiropractor PastSince Mar 1, 2002 Accepting new patients

Locations

10171 Chumstick Hwy
Ste 1
Leavenworth, WA 98826
Phone (509) 548-3133

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.

NPI Registry JSON

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461715200000",
    "number": "1679615678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "603 N MISSION ST",
            "city": "WENATCHEE",
            "state": "WA",
            "postal_code": "988012049",
            "telephone_number": "509-884-4357",
            "fax_number": "509-888-4601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "739 SOUTH MISSION ST.",
            "city": "WENATCHEE",
            "state": "WA",
            "postal_code": "98801",
            "telephone_number": "509-665-7208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LATIMER",
        "first_name": "WAYNE",
        "middle_name": "MARK",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-13",
        "last_updated": "2016-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "WA",
            "license": "3606",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH00003031",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WA ST. LABOR AND INDUSTRY",
            "identifier": "0159778",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wenatchee, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2016; 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.