Individual provider Active NPI

Kyla Nakamura, DC

  • Chiropractor
  • Bonney Lake, WA
National Provider Identifier
1699339291
Registry record updated Feb 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH60940276 Issued in WA
Practice address
9812 205TH Ave E Ste C
Bonney Lake, WA 98391-8275
Phone
(253) 863-6378
NPI assigned
Apr 29, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH60940276 WA Primary

Addresses

Primary practice location

9812 205TH Ave E Ste C
Bonney Lake, WA 98391-8275

Mailing address

9812 205TH Ave E Ste C
Bonney Lake, WA 98391-8275
Phone (253) 863-6378

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190604000726 WA Practitioner - Chiropractic 7618200866 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - West Sunnyvale, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mountain View Chirorpactic PLLCGroup PAC ID 9537174123, 6 clinicians

Practice addresses (Care Compare)

9812 205TH Ave E
Suite C
Bonney Lake, WA 98391-8382
Phone (253) 863-6378

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH60940276WAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Mountain View Chirorpactic PLLC Chiropractor CurrentSince May 1, 2021 Accepting new patients
Stemp Family Chiropractic, LLC Chiropractor CurrentSince May 6, 2019 Accepting new patients

Locations

9812 205th Ave E
Ste C
Bonney Lake, WA 98391
Phone (253) 863-6378

6915 Lakewood Dr W
Ste A2
University Place, WA 98467
Phone (253) 474-4226

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1556496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676246400000",
    "number": "1699339291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9812 205TH AVE E STE C",
            "city": "BONNEY LAKE",
            "state": "WA",
            "postal_code": "983918275",
            "telephone_number": "253-863-6378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9812 205TH AVE E STE C",
            "city": "BONNEY LAKE",
            "state": "WA",
            "postal_code": "983918275",
            "telephone_number": "253-863-6378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAKAMURA",
        "first_name": "KYLA",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-29",
        "last_updated": "2023-02-13",
        "certification_date": "2023-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH60940276",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bonney Lake, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2023; 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.