NPIMap

Organization Active NPI

Integrative Medical Solutions PLLC

Doing business as Kingston Crossing Wellness

  • Chiropractor
  • Kingston, WA
National Provider Identifier
1740873397
Registry record updated Feb 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
INTEGRATIVE MEDICAL SOLUTIONS PLLC
Doing business as
Kingston Crossing Wellness
Practice address
8202 NE State Highway 104 Ste 105
Kingston, WA 98346-9454
Phone
(360) 297-0037
Fax
(360) 297-0420
NPI assigned
Feb 15, 2021
Last updated
Feb 15, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2021

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

Authorized official

Name
Dr. Rayshel Stanton
Title
Office Manager
Phone
(360) 297-0037

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X Primary
Clinic/Center 261Q00000X
Multi-Specialty Clinic/Center 261QM1300X
Durable Medical Equipment & Medical Supplies 332B00000X

Addresses

Primary practice location

8202 NE State Highway 104 Ste 105
Kingston, WA 98346-9454

Mailing address

8202 NE State Highway 104 Ste 105
Kingston, WA 98346-9454
Phone (360) 297-0037

Other names 1

  • Kingston Crossing Wellness Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210810002338 WA Part B Supplier - Clinic/Group Practice 7012311285 Receives reassigned benefits from 2 practitioners
Practice locations: Kingston, WA

National Provider Directory

National Provider Directory

Locations

8202 NE State Highway 104
Kingston, WA 98346
Phone (206) 450-3987

8202 NE State Highway 104
Ste 105
Kingston, WA 98346
Phone (360) 297-0037

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1613347200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1613347200000",
    "number": "1740873397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8202 NE STATE HIGHWAY 104 STE 105",
            "city": "KINGSTON",
            "state": "WA",
            "postal_code": "983469454",
            "telephone_number": "360-297-0037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8202 NE STATE HIGHWAY 104 STE 105",
            "city": "KINGSTON",
            "state": "WA",
            "postal_code": "983469454",
            "telephone_number": "360-297-0037",
            "fax_number": "360-297-0420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATIVE MEDICAL SOLUTIONS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-15",
        "last_updated": "2021-02-15",
        "certification_date": "2021-02-03",
        "status": "A",
        "authorized_official_last_name": "STANTON",
        "authorized_official_first_name": "RAYSHEL",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "360-297-0037",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kingston Crossing Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kingston, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2021; 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.