Organization Active NPI

Burlington Chiropractic Clinic, Inc. PS

  • Chiropractor
  • Burlington, WA
National Provider Identifier
1801039185
Registry record updated May 13, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3117 Issued in WA
Legal business name
BURLINGTON CHIROPRACTIC CLINIC, INC. PS
Practice address
249 S Burlington Blvd
Burlington, WA 98233-1708
Phone
(360) 755-1414
Fax
(360) 755-0172
NPI assigned
Apr 15, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 13, 2009

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

Authorized official

Name
Dr. Kevin S. Geagan, D.C.NPI 1821145657
Title
President
Phone
(360) 755-1414

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 3117 WA Primary

Addresses

Primary practice location

249 S Burlington Blvd
Burlington, WA 98233-1708

Mailing address

249 S Burlington Blvd
Burlington, WA 98233-1708
Phone (360) 755-1414

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090519000334 WA Part B Supplier - Clinic/Group Practice 4082763214 Receives reassigned benefits from 1 practitioner
Practice locations: Burlington, WA

National Provider Directory

National Provider Directory

Locations

249 S Burlington Blvd
Burlington, WA 98233
Phone (360) 755-1414

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1239753600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1242172800000",
    "number": "1801039185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "249 S BURLINGTON BLVD",
            "city": "BURLINGTON",
            "state": "WA",
            "postal_code": "982331708",
            "telephone_number": "360-755-1414",
            "fax_number": "360-755-0172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "249 S BURLINGTON BLVD",
            "city": "BURLINGTON",
            "state": "WA",
            "postal_code": "982331708",
            "telephone_number": "360-755-1414",
            "fax_number": "360-755-0172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BURLINGTON CHIROPRACTIC CLINIC, INC. PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-15",
        "last_updated": "2009-05-13",
        "status": "A",
        "authorized_official_last_name": "GEAGAN",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "360-755-1414",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "3117",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlington, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2009; 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.