NPIMap

Organization Active NPI

Vitality Chiropractic Center, Inc.

  • Health Service Clinic/Center
  • Bellevue, WA
National Provider Identifier
1689871659
Registry record updated Oct 1, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
License
CH00003453 Issued in WA
Legal business name
VITALITY CHIROPRACTIC CENTER, INC.
Practice address
410 Bellevue Way SE Ste 202
Bellevue, WA 98004-6649
Phone
(425) 378-1800
Fax
(425) 462-1802
NPI assigned
Jul 2, 2007
Last updated
Oct 1, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2014

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

Authorized official

Name
Dr. Corey Taylor Ebbin, D.C.NPI 1821158932
Title
President
Phone
(425) 378-1800

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X CH00003453 WA Primary

Addresses

Primary practice location

410 Bellevue Way SE Ste 202
Bellevue, WA 98004-6649

Mailing address

410 Bellevue Way SE Ste 202
Bellevue, WA 98004-6649
Phone (425) 378-1800

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041105001061 WA Part B Supplier - Clinic/Group Practice 9335102706 Receives reassigned benefits from 1 practitioner
Practice locations: Bellevue, WA

National Provider Directory

National Provider Directory
Tax ID family
Vitality Chiropractic Center Inc2 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 5

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": "1183334400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1412121600000",
    "number": "1689871659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 BELLEVUE WAY SE STE 202",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980046649",
            "telephone_number": "425-378-1800",
            "fax_number": "425-462-1802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 BELLEVUE WAY SE STE 202",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980046649",
            "telephone_number": "425-378-1800",
            "fax_number": "425-462-1802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VITALITY CHIROPRACTIC CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-02",
        "last_updated": "2014-10-01",
        "status": "A",
        "authorized_official_last_name": "EBBIN",
        "authorized_official_first_name": "COREY",
        "authorized_official_middle_name": "TAYLOR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "425-378-1800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "WA",
            "license": "CH00003453",
            "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 1, 2014; 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.