Individual provider Active NPI

Eric Vogelzang, D.C.

  • Chiropractor
  • Vancouver, WA
National Provider Identifier
1750768701
Registry record updated Feb 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH 60530989 Issued in WA
Practice address
1001 Broadway St Unit 200
Vancouver, WA 98660-3296
Phone
(360) 828-1574
Fax
(360) 574-6430
NPI assigned
Apr 29, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH 60530989 WA Primary

Addresses

Primary practice location

1001 Broadway St Unit 200
Vancouver, WA 98660-3296

Mailing address

13712 NE 20TH Ave
Vancouver, WA 98686-2698
Phone (360) 574-5944

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230801001319 MI Practitioner - Chiropractic 3476866807 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH 60530989WAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Chirohealth and Wellness PLC Chiropractor CurrentSince Jun 10, 2023 Accepting new patients
Bridge Chiropractic 5 LLC Chiropractor CurrentSince Feb 18, 2021 Accepting new patients

Locations

2213 Wealthy St SE
Ste 220
Grand Rapids, MI 49506
Phone (616) 458-2342

1001 Broadway St
Unit 200
Vancouver, WA 98660
Phone (360) 574-5944

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1430265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613692800000",
    "number": "1750768701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13712 NE 20TH AVE",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986862698",
            "telephone_number": "360-574-5944",
            "fax_number": "360-574-6430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 BROADWAY ST UNIT 200",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986603296",
            "telephone_number": "360-828-1574",
            "fax_number": "360-574-6430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VOGELZANG",
        "first_name": "ERIC",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-29",
        "last_updated": "2021-02-19",
        "certification_date": "2021-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH 60530989",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Feb 19, 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.