NPIMap

Organization Active NPI

David Hendrickson D.C.PS

  • Chiropractor
  • Tacoma, WA
National Provider Identifier
1811330236
Registry record updated Apr 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH00002584 Issued in WA
Legal business name
DAVID HENDRICKSON D.C.PS
Practice address
5015 Tacoma Mall Blvd # 102
Tacoma, WA 98409-7107
Phone
(253) 472-4400
NPI assigned
Apr 16, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2013

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

Authorized official

Name
Dr. David Hendrickson, D.C.NPI 1841379435
Title
President
Phone
(253) 472-4400

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 CH00002584 WA Primary

Addresses

Primary practice location

5015 Tacoma Mall Blvd # 102
Tacoma, WA 98409-7107

Mailing address

5015 Tacoma Mall Blvd # 102
Tacoma, WA 98409-7107
Phone (253) 472-4400

Other names 1

  • Discover Life Chiropractic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130424000517 WA Part B Supplier - Clinic/Group Practice 4284870098 Receives reassigned benefits from 2 practitioners
Practice locations: Tacoma, WA

National Provider Directory

National Provider Directory

Locations

5015 Tacoma Mall Blvd
#E10
Tacoma, WA 98409

5015 Tacoma Mall Blvd
Ste E102
Tacoma, WA 98409
Phone (253) 472-4400

Practitioners & affiliated clinicians

Practitioners 7

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": "1366070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1367280000000",
    "number": "1811330236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5015 TACOMA MALL BLVD # 102",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984097107",
            "telephone_number": "253-472-4400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5015 TACOMA MALL BLVD # 102",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984097107",
            "telephone_number": "253-472-4400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID HENDRICKSON D.C.PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-16",
        "last_updated": "2013-04-30",
        "status": "A",
        "authorized_official_last_name": "HENDRICKSON",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "253-472-4400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH00002584",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Discover Life Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tacoma, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2013; 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.