Individual provider Active NPI

John J Sim, DC

  • Chiropractor
  • Lynnwood, WA
National Provider Identifier
1699872093
Registry record updated Apr 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH00034211 Issued in WA
Practice address
16303 Highway 99
Suite 1B
Lynnwood, WA 98087-1453
Phone
(425) 743-9460
Fax
(425) 743-9409
NPI assigned
Sep 20, 2006
Last updated
Apr 1, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH00034211 WA Primary

Addresses

Primary practice location

16303 Highway 99
Suite 1B
Lynnwood, WA 98087-1453

Mailing address

16303 Highway 99
Suite 1B
Lynnwood, WA 98087-1453
Phone (425) 743-9460

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040216001064 WA Practitioner - Chiropractic 3870488224 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH00034211WAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Corbin Chiropractic Clinic PLLC Chiropractor PastSince Dec 31, 2013 Accepting new patients

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364774400000",
    "number": "1699872093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16303 HIGHWAY 99",
            "address_2": "SUITE 1B",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980871453",
            "telephone_number": "425-743-9460",
            "fax_number": "425-743-9409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16303 HIGHWAY 99",
            "address_2": "SUITE 1B",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980871453",
            "telephone_number": "425-743-9460",
            "fax_number": "425-743-9409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIM",
        "first_name": "JOHN",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2013-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH00034211",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynnwood, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2013; 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.