Caedin T Pettigrew, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CH00034043 Issued in WA

Practice address

13030 121St Way NE
Suite 102
Kirkland, WA 98034-7210

Phone

(425) 814-2800

Fax

(425) 823-0882

NPI assigned

Aug 24, 2005

Last updated

Jan 13, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Specialty

Chiropractic

Education

Northwestern College of Chiropractic, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Functional Health Consulting LLCGroup PAC ID 1759560709, 36 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Functional Health Consulting, LLC

  dba Vida Integrated Health

  • Sports Physician Chiropractor
  • Seattle, WA
  • NPI 1871801522
  Medicare reassignment Care Compare group NPD
• Functional Health Consulting, LLC

  dba Vida Integrated Health

  • Sports Physician Chiropractor
  • Seattle, WA
  • NPI 1538645288
  NPD
• Functional Health Consulting, LLC

  dba Vida Integrated Health

  • Chiropractor
  • Renton, WA
  • NPI 1598548877
  NPD
• Functional Health Consulting, LLC

  dba Vida Integrated Health

  • Rehabilitation Chiropractor
  • Everett, WA
  • NPI 1619226891
  NPD (past)

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

{
    "created_epoch": "1124841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578873600000",
    "number": "1689667743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13030 121ST WAY NE",
            "address_2": "SUITE 102",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980347210",
            "telephone_number": "425-814-2800",
            "fax_number": "425-823-0882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13030 121ST WAY NE",
            "address_2": "SUITE 102",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980347210",
            "telephone_number": "425-814-2800",
            "fax_number": "425-823-0882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTIGREW",
        "first_name": "CAEDIN",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-08-24",
        "last_updated": "2020-01-13",
        "certification_date": "2020-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH00034043",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WA DEPT OF LABOR & INDUSTRIES",
            "identifier": "0395157",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERA WORKER'S COMP",
            "identifier": "192264900",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "G8984222",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kirkland@thinkvida.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "email",
            "address_1": "13030 121st Way NE",
            "address_2": "Suite 102",
            "city": "Kirkland",
            "state": "WA",
            "country_code": "US",
            "postal_code": "980347210",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "kirkland@thinkvida.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "13030 121st Way NE",
            "address_2": "Suite 102",
            "city": "Kirkland",
            "state": "WA",
            "country_code": "US",
            "postal_code": "980347210",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Robert Petit, ARNP
• Alan Petkov, DDS
• Sarah Elise Petricca, M.D.
• Trevor W. Petrie, OTR/L, CHT
• Elizabeth Marie Petrovics, RN
• Taryn Kelly Pfeifer, RN
• Jenny Pham
• John Pham
• Linhchi Pham, MD
• Terrence A Pheifer, M.D.

• Chiropractor in Kirkland, WA
• Providers in Kirkland, WA by specialty
• Chiropractor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2020; 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.