Individual provider Active NPI

Robert Wayne Allen, D.C.,CCSP,CKTI

  • Chiropractor
  • Vancouver, WA
National Provider Identifier
1740473602
Registry record updated May 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH00001732 Issued in WA
Practice address
811 NE 112TH Ave Ste 101
Vancouver, WA 98684-4944
Phone
(360) 892-2226
Fax
(360) 892-1204
NPI assigned
Aug 23, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 29, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH00001732 WA Primary

Addresses

Primary practice location

811 NE 112TH Ave Ste 101
Vancouver, WA 98684-4944

Mailing address

811 NE 112TH Ave Ste 101
Vancouver, WA 98684-4944
Phone (360) 892-2226

Other identifiers 5

IdentifierTypeStateIssuer
AB10115OtherMEDICARE GROUP
AB10327OtherMEDICARE INDIVIDUAL
1356392765OtherNPI INDIVIDUAL
350007584OtherMEDICARE RAILROAD
T02545OtherUPIN

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)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Massage by Cecelia CurrentSince Dec 15, 2019 Accepting new patients

Locations

811 NE 112th Ave
Ste 101
Vancouver, WA 98684
Phone (360) 892-2226

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.

NPI Registry JSON

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

{
    "created_epoch": "1187827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212019200000",
    "number": "1740473602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "811 NE 112TH AVE STE 101",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986844944",
            "telephone_number": "360-892-2226",
            "fax_number": "360-892-1204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "811 NE 112TH AVE STE 101",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986844944",
            "telephone_number": "360-892-2226",
            "fax_number": "360-892-1204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLEN",
        "first_name": "ROBERT",
        "middle_name": "WAYNE",
        "credential": "D.C.,CCSP,CKTI",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-08-23",
        "last_updated": "2008-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH00001732",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP",
            "identifier": "AB10115",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE INDIVIDUAL",
            "identifier": "AB10327",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI  INDIVIDUAL",
            "identifier": "1356392765",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "350007584",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UPIN",
            "identifier": "T02545",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.