NPIMap

Organization Active NPI

Prentice Family Chiropractic Inc PS

  • Chiropractor
  • Kirkland, WA
National Provider Identifier
1700965563
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2222 Issued in WA
Legal business name
PRENTICE FAMILY CHIROPRACTIC INC PS
Practice address
13904 100TH Ave NE
Kirkland, WA 98034-5231
Phone
(425) 820-5888
Fax
(425) 820-5022
NPI assigned
Nov 3, 2006
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
Dr. Daniel Wayne Prentice, DCNPI 1972682730
Title
Owner
Phone
(425) 820-5888

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 2222 WA Primary

Addresses

Primary practice location

13904 100TH Ave NE
Kirkland, WA 98034-5231

Mailing address

13904 100TH Ave NE
Kirkland, WA 98034-5231
Phone (425) 820-5888

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080501000064 WA Part B Supplier - Clinic/Group Practice 7113006263 Receives reassigned benefits from 1 practitioner
Practice locations: Kirkland, WA

National Provider Directory

National Provider Directory

Locations

13904 100th Ave NE
Kirkland, WA 98034
Phone (425) 820-5888

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1162512000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1700965563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13904 100TH AVE NE",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980345231",
            "telephone_number": "425-820-5888",
            "fax_number": "425-820-5022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13904 100TH AVE NE",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980345231",
            "telephone_number": "425-820-5888",
            "fax_number": "425-820-5022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRENTICE FAMILY CHIROPRACTIC INC PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PRENTICE",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "425-820-5888",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "2222",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kirkland, 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.