Individual provider Active NPI

Gina M Wolf, DC

  • Chiropractor
  • Spokane Valley, WA
National Provider Identifier
1750431474
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH00002966 Issued in WA
Practice address
15404 E Springfield Ave
Suite 100
Spokane Valley, WA 99037-8569
Phone
(509) 892-9800
Fax
(509) 892-9998
NPI assigned
Jan 12, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH00002966 WA Primary

Addresses

Primary practice location

15404 E Springfield Ave
Suite 100
Spokane Valley, WA 99037-8569

Mailing address

15404 E Springfield Ave
Suite 100
Spokane Valley, WA 99037-8569
Phone (509) 892-9800

Other identifiers 1

IdentifierTypeStateIssuer
0193196OtherWALABOR & INDUSTRIES

Other names 1

  • Gina M Trautman Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031204000338 WA Practitioner - Chiropractic 6305741232 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gina M Wolf DC PSGroup PAC ID 8527013945, 2 clinicians

Practice addresses (Care Compare)

15404 E Springfield Ave
Spokane Valley, WA 99037-8569
Phone (509) 892-9800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH00002966WAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Gina M Wolf DC PS Chiropractor CurrentSince Jan 1, 2005 Accepting new patients
Spinal & Sports Care Clinic P S Chiropractor PastSince Aug 1, 1999 Accepting new patients

Locations

1625 W 4th Ave
Lowr 200
Spokane, WA 99201
Phone (509) 560-4658

15404 E Springfield Ave
Ste 100
Spokane Valley, WA 99037
Phone (509) 892-9800

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": "1168560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1750431474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15404 E SPRINGFIELD AVE",
            "address_2": "SUITE 100",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "990378569",
            "telephone_number": "509-892-9800",
            "fax_number": "509-892-9998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15404 E SPRINGFIELD AVE",
            "address_2": "SUITE 100",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "990378569",
            "telephone_number": "509-892-9800",
            "fax_number": "509-892-9998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLF",
        "first_name": "GINA",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH00002966",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR & INDUSTRIES",
            "identifier": "0193196",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GINA",
            "last_name": "TRAUTMAN",
            "middle_name": "M",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Spokane Valley, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.