Organization Active NPI

Savannah Chiropractic Clinic

Doing business as Peterson Family Chiropractic

  • Chiropractor
  • Arlington, WA
National Provider Identifier
1679750558
Registry record updated Mar 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
SAVANNAH CHIROPRACTIC CLINIC
Doing business as
Peterson Family Chiropractic
Practice address
415 N Olympic Ave
Arlington, WA 98223
Phone
(360) 435-9200
Fax
(360) 435-5047
NPI assigned
Jan 23, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2011

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

Authorized official

Name
Dr. Melanie L Bober, DC
Title
Vice President
Phone
(360) 435-9200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

415 N Olympic Ave
Arlington, WA 98223

Mailing address

415 N Olympic Ave
Arlington, WA 98223
Phone (360) 435-9200

Other names 1

  • Peterson Family Chiropractic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031210000530 WA Part B Supplier - Clinic/Group Practice 1557267531 Receives reassigned benefits from 1 practitioner
Practice locations: Arlington, WA

National Provider Directory

National Provider Directory

Locations

415 N Olympic Ave
Arlington, WA 98223
Phone (360) 435-9200

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1201046400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1299715200000",
    "number": "1679750558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 N OLYMPIC AVE",
            "city": "ARLINGTON",
            "state": "WA",
            "postal_code": "98223",
            "telephone_number": "360-435-9200",
            "fax_number": "360-435-5047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 N OLYMPIC AVE",
            "city": "ARLINGTON",
            "state": "WA",
            "postal_code": "98223",
            "telephone_number": "360-435-9200",
            "fax_number": "360-435-5047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAVANNAH CHIROPRACTIC CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-23",
        "last_updated": "2011-03-10",
        "status": "A",
        "authorized_official_last_name": "BOBER",
        "authorized_official_first_name": "MELANIE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "360-435-9200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Peterson Family Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Arlington, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2011; 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.