Individual provider Active NPI

Douglas Smith, DC

  • Chiropractor
  • Port Orchard, WA
National Provider Identifier
1720195761
Registry record updated Jun 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH3166 Issued in WA
Practice address
1501 Pottery Ave
Port Orchard, WA 98366-3712
Phone
(360) 876-6865
Fax
(360) 876-5507
NPI assigned
Aug 24, 2006
Last updated
Jun 24, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH3166 WA Primary

Addresses

Primary practice location

1501 Pottery Ave
Port Orchard, WA 98366-3712

Mailing address

1501 Pottery Ave
Port Orchard, WA 98366-3712
Phone (360) 876-6865

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040527000282 WA Practitioner - Chiropractic 0840271623 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH3166WAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Spinal Health Care Center Chiropractor CurrentSince May 21, 1997 Accepting new patients
Action Chiropratic Chiropractor Past Accepting new patients

Locations

1501 Pottery Ave
Port Orchard, WA 98366
Phone (253) 223-3538

11871 Silverdale Way NW
Ste 109
Silverdale, WA 98383
Phone (360) 710-7491

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, 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": "1156377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403568000000",
    "number": "1720195761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 POTTERY AVE",
            "city": "PORT ORCHARD",
            "state": "WA",
            "postal_code": "983663712",
            "telephone_number": "360-876-6865",
            "fax_number": "360-876-5507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 POTTERY AVE",
            "city": "PORT ORCHARD",
            "state": "WA",
            "postal_code": "983663712",
            "telephone_number": "360-876-6865",
            "fax_number": "360-876-5507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "DOUGLAS",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-24",
        "last_updated": "2014-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH3166",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Orchard, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 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.