Organization Active NPI

Pure Chiropractic 1 PLLC

  • Chiropractor
  • Bellevue, WA
National Provider Identifier
1689728453
Registry record updated Oct 25, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
PURE CHIROPRACTIC 1 PLLC
Practice address
15015 Main St
Suite 106
Bellevue, WA 98007-5229
Phone
(425) 643-4454
NPI assigned
Jan 22, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2007

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

Authorized official

Name
Dr. Jeremy John Welch, D,C,NPI 1144398785
Title
Chiropractor
Phone
(425) 643-4454

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

15015 Main St
Suite 106
Bellevue, WA 98007-5229

Mailing address

15015 Main St
Suite 106
Bellevue, WA 98007-5229
Phone (425) 643-4454

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070207000084 WA Part B Supplier - Clinic/Group Practice 8527060375 Receives reassigned benefits from 1 practitioner
Practice locations: Bellevue, WA

National Provider Directory

National Provider Directory
Tax ID family
Pure Chiropractic 1 PLLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

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": "1169424000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193270400000",
    "number": "1689728453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15015 MAIN ST",
            "address_2": "SUITE 106",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980075229",
            "telephone_number": "425-643-4454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15015 MAIN ST",
            "address_2": "SUITE 106",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980075229",
            "telephone_number": "425-643-4454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PURE CHIROPRACTIC 1 PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-22",
        "last_updated": "2007-10-25",
        "status": "A",
        "authorized_official_last_name": "WELCH",
        "authorized_official_first_name": "JEREMY",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "425-643-4454",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D,C,"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "WA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2007; 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.