NPIMap

Organization Active NPI

Vert. Fitness & Wellness Center, LLC

Doing business as Vert Chiropractic

  • Chiropractor
  • Lacey, WA
National Provider Identifier
1699330373
Registry record updated Dec 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
VERT. FITNESS & WELLNESS CENTER, LLC
Doing business as
Vert Chiropractic
Practice address
4444 Lacey Blvd SE Ste E
Lacey, WA 98503-5730
Phone
(360) 999-9848
NPI assigned
May 7, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2023

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

Authorized official

Name
Trevor Marum, DCNPI 1831638675
Title
Owner
Phone
(360) 999-9848

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 Primary

Addresses

Primary practice location

4444 Lacey Blvd SE Ste E
Lacey, WA 98503-5730

Mailing address

4444 Lacey Blvd SE Ste E
Lacey, WA 98503-5730
Phone (360) 999-9848

Other identifiers 1

IdentifierTypeStateIssuer
2134869MedicaidWA

Other names 1

  • Vert Chiropractic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190615000211 WA Part B Supplier - Clinic/Group Practice 6204169774 Receives reassigned benefits from 1 practitioner
Practice locations: Lacey, WA

National Provider Directory

National Provider Directory

Locations

3945 8th Ave SE
Lacey, WA 98503
Phone (360) 999-9848

4444 Lacey Blvd SE
Ste E
Olympia, WA 98503
Phone (360) 438-1998

Practitioners & affiliated clinicians

Practitioners 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1557187200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1702857600000",
    "number": "1699330373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4444 LACEY BLVD SE STE E",
            "city": "LACEY",
            "state": "WA",
            "postal_code": "985035730",
            "telephone_number": "360-999-9848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4444 LACEY BLVD SE STE E",
            "city": "LACEY",
            "state": "WA",
            "postal_code": "985035730",
            "telephone_number": "360-999-9848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VERT. FITNESS & WELLNESS CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-07",
        "last_updated": "2023-12-18",
        "certification_date": "2023-12-18",
        "status": "A",
        "authorized_official_last_name": "MARUM",
        "authorized_official_first_name": "TREVOR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "360-999-9848",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2134869",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vert Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lacey, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2023; 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.