Organization Active NPI

Hoquiam Chiropractic Inc PS

  • Chiropractor
  • Hoquiam, WA
National Provider Identifier
1689797813
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1332 Issued in WA
Legal business name
HOQUIAM CHIROPRACTIC INC PS
Practice address
2223 Simpson Ave
Hoquiam, WA 98550
Phone
(360) 533-6400
Fax
(360) 533-6465
NPI assigned
Apr 10, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mark R Van HemertNPI 1215941034
Title
President
Phone
(360) 533-6400

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: 193200000X MULTI-SPECIALTY GROUP 111N00000X 1332 WA Primary

Addresses

Primary practice location

2223 Simpson Ave
Hoquiam, WA 98550

Mailing address

2223 Simpson Ave
Hoquiam, WA 98550
Phone (360) 533-6400

Other identifiers 1

IdentifierTypeStateIssuer
18867OtherWADEPT OF L & I

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120327000463 WA Part B Supplier - Clinic/Group Practice 8022278167 Receives reassigned benefits from 1 practitioner
Practice locations: Hoquiam, WA

National Provider Directory

National Provider Directory

Locations

320 23rd St
Hoquiam, WA 98550
Phone (360) 533-6400

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1689797813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2223 SIMPSON AVE",
            "city": "HOQUIAM",
            "state": "WA",
            "postal_code": "98550",
            "telephone_number": "360-533-6400",
            "fax_number": "360-533-6465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2223 SIMPSON AVE",
            "city": "HOQUIAM",
            "state": "WA",
            "postal_code": "98550",
            "telephone_number": "360-533-6400",
            "fax_number": "360-533-6465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOQUIAM CHIROPRACTIC INC PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "VAN HEMERT",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "360-533-6400"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "1332",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT OF L & I",
            "identifier": "18867",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hoquiam, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.