Individual provider Active NPI

David Robert Kreider, D.C.

  • Chiropractor
  • Bellevue, WA
National Provider Identifier
1780995522
Registry record updated Jun 26, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
603021969 Issued in WA
Practice address
1750 112TH Ave NE
Suite B210
Bellevue, WA 98004-3752
Phone
(425) 467-6633
Fax
(425) 455-8914
NPI assigned
Jun 26, 2010
Last updated
Jun 26, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 603021969 WA Primary

Addresses

Primary practice location

1750 112TH Ave NE
Suite B210
Bellevue, WA 98004-3752

Mailing address

1750 112TH Ave NE
Suite B210
Bellevue, WA 98004-3752
Phone (425) 467-6633

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
603021969WAMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1277510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277510400000",
    "number": "1780995522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1750 112TH AVE NE",
            "address_2": "SUITE B210",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980043752",
            "telephone_number": "425-467-6633",
            "fax_number": "425-455-8914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1750 112TH AVE NE",
            "address_2": "SUITE B210",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980043752",
            "telephone_number": "425-467-6633",
            "fax_number": "425-455-8914"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KREIDER",
        "first_name": "DAVID",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-26",
        "last_updated": "2010-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "603021969",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2010; 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.