Mobile Sport Rehab Wellness

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

MOBILE SPORT REHAB WELLNESS

Practice address

4444 NE Sunset Blvd Ste 2
Renton, WA 98059-4018

Phone

(425) 919-8700

NPI assigned

Jun 25, 2021

Organization subpart

No

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

Authorized official

Name

David Ingram, DCNPI 1013143148

Title

Owner

Phone

(425) 919-8700

Specialties & licenses 1

Addresses

Other names 1

• Family Chiropractic and Massage Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• David Ingram Jr., D.C.

  • Chiropractor
  • Centreville, VA
  • NPI 1013143148
  NPD Authorized official

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

{
    "created_epoch": "1624579200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1624579200000",
    "number": "1770153546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4444 NE SUNSET BLVD STE 2",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980594018",
            "telephone_number": "425-919-8700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4444 NE SUNSET BLVD STE 2",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980594018",
            "telephone_number": "425-919-8700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOBILE SPORT REHAB WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-25",
        "last_updated": "2021-06-25",
        "certification_date": "2021-06-24",
        "status": "A",
        "authorized_official_last_name": "INGRAM",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "425-919-8700",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family Chiropractic and Massage",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Myesha Mitchell
• Taryn Reiko Miyaoka, PA-C
• Hikari Daniel Mizukami, DPT
• Rachel Mlanao, MD
• Sara Ahmed Moallin
• Mobility Sports Chiro PLLC
• Keonna Moffett, LICSW
• Lul Mohamed
• Meghan K Mohs
• Yass Moinpour, M.D.

• Chiropractor in Renton, WA
• Providers in Renton, WA by specialty
• Chiropractor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2021; 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.