Active NPI
Jerry Wang, D.C.
- Chiropractor
- Bellevue, WA
National Provider Identifier
1740320795
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 3517
- Practice address
- 1750 112TH Ave NE Ste C240
Bellevue, WA 98004-5233 - Phone
- (425) 688-1994
- Fax
- (425) 688-1990
- NPI assigned
- Feb 7, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 3517 | WA | Primary |
Addresses
Primary practice location
1750 112TH Ave NE Ste C240
Bellevue, WA 98004-5233
Mailing address
1750 112TH Ave NE Ste C240
Bellevue, WA 98004-3727
Phone (425) 688-1994
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3517 | WA | MD | Geriatric Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dr. Jerry Wang, D.C., P.S., Inc. | Chiropractor | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Chiropractor
- Bellevue, WA
- NPI 1053435214
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170806400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1462752000000",
"number": "1740320795",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1750 112TH AVE NE STE C240",
"city": "BELLEVUE",
"state": "WA",
"postal_code": "980043727",
"telephone_number": "425-688-1994",
"fax_number": "425-688-1990"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1750 112TH AVE NE STE C240",
"city": "BELLEVUE",
"state": "WA",
"postal_code": "980045233",
"telephone_number": "425-688-1994",
"fax_number": "425-688-1990"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WANG",
"first_name": "JERRY",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-07",
"last_updated": "2016-05-09",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "WA",
"license": "3517",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bellevue, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.