Active NPI
William P. Momyer, D.C.
- Chiropractor
- Kent, WA
National Provider Identifier
1801952445
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- CH00001316
- Practice address
- 24612 104TH Ave SE
Kent, WA 98030-4965 - Phone
- (253) 859-2373
- Fax
- (253) 856-8754
- NPI assigned
- Dec 28, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | CH00001316 | WA | Primary |
Addresses
Primary practice location
24612 104TH Ave SE
Kent, WA 98030-4965
Mailing address
24612 104TH Ave SE
Kent, WA 98030-4965
Phone (253) 859-2373
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 990251585 9824KE | Other | WA | REGENCE BLUE SHIELD |
| 0034012 | Other | WA | DEPT L&I NUMBER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Sherman College of Straight Chiropractic, 1977
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
24604 104TH Ave SE
Kent, WA 98030-5385
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CH00001316 | WA | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Momyer Chiropractic and Massage, P.S. | Chiropractor | Current | Accepting new patients |
| Audrey M.K. Yan | Past | Accepting new patients |
Locations
24604 104th Ave SE
Kent, WA 98030
Phone (206) 353-8146
24604 104th Ave SE
Ste 203
Kent, WA 98030
Phone (253) 859-2373
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.
-
- Chiropractor
- Kent, WA
- NPI 1215165824
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167264000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1801952445",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "24612 104TH AVE SE",
"city": "KENT",
"state": "WA",
"postal_code": "980304965",
"telephone_number": "253-859-2373",
"fax_number": "253-856-8754"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "24612 104TH AVE SE",
"city": "KENT",
"state": "WA",
"postal_code": "980304965",
"telephone_number": "253-859-2373",
"fax_number": "253-856-8754"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOMYER",
"first_name": "WILLIAM",
"middle_name": "P.",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-12-28",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "WA",
"license": "CH00001316",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGENCE BLUE SHIELD",
"identifier": "990251585 9824KE",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DEPT L&I NUMBER",
"identifier": "0034012",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Kent, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.