NPIMap

Organization Active NPI

Queen Anne Chiropractic Inc, P.S.

Doing business as Queen Anne Chiropractic Center

  • Chiropractor
  • Seattle, WA
National Provider Identifier
1821267659
Registry record updated Apr 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
602380628 Issued in WA
Legal business name
QUEEN ANNE CHIROPRACTIC INC, P.S.
Doing business as
Queen Anne Chiropractic Center
Practice address
1905 Queen Anne Ave N
Seattle, WA 98109-2500
Phone
(206) 282-8275
Fax
(206) 282-8784
NPI assigned
Feb 26, 2008
Last updated
Apr 23, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2008

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

Authorized official

Name
Dr. Darrell Irwin Gibson, D.C.NPI 1689703019
Title
Owner
Phone
(206) 282-8275

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: 193200000X MULTI-SPECIALTY GROUP 111N00000X 602380628 WA Primary

Addresses

Primary practice location

1905 Queen Anne Ave N
Seattle, WA 98109-2500

Mailing address

1905 Queen Anne Ave N
Seattle, WA 98109-2500
Phone (206) 282-8275

Other names 1

  • Queen Anne Chiropractic Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080424000038 WA Part B Supplier - Clinic/Group Practice 2769560242 Receives reassigned benefits from 3 practitioners
Practice locations: Seattle, WA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1203984000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208908800000",
    "number": "1821267659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1905 QUEEN ANNE AVE N",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981092500",
            "telephone_number": "206-282-8275",
            "fax_number": "206-282-8784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1905 QUEEN ANNE AVE N",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981092500",
            "telephone_number": "206-282-8275",
            "fax_number": "206-282-8784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QUEEN ANNE CHIROPRACTIC INC, P.S.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-26",
        "last_updated": "2008-04-23",
        "status": "A",
        "authorized_official_last_name": "GIBSON",
        "authorized_official_first_name": "DARRELL",
        "authorized_official_middle_name": "IRWIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "206-282-8275",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "602380628",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Queen Anne Chiropractic Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2008; 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.