Individual provider Active NPI

Jason Corey Gilmore, DC

  • Chiropractor
  • Kirkland, WA
National Provider Identifier
1780698662
Registry record updated Feb 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH00034001 Issued in WA
Practice address
13030 121St Way NE
Suite 102
Kirkland, WA 98034-7210
Phone
(425) 814-2800
Fax
(425) 823-0882
NPI assigned
Jul 28, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 19, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH00034001 WA Primary

Addresses

Primary practice location

13030 121St Way NE
Suite 102
Kirkland, WA 98034-7210

Mailing address

13030 121St Way NE
Suite 102
Kirkland, WA 98034-7210
Phone (425) 814-2800

Other identifiers 1

IdentifierTypeStateIssuer
0295582OtherWALABOR & INDUSTRY

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

NPI Registry JSON

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1518998400000",
    "number": "1780698662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13030 121ST WAY NE",
            "address_2": "SUITE 102",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980347210",
            "telephone_number": "425-814-2800",
            "fax_number": "425-823-0882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13030 121ST WAY NE",
            "address_2": "SUITE 102",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980347210",
            "telephone_number": "425-814-2800",
            "fax_number": "425-823-0882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILMORE",
        "first_name": "JASON",
        "middle_name": "COREY",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-28",
        "last_updated": "2018-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH00034001",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR & INDUSTRY",
            "identifier": "0295582",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kirkland, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2018; 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.