NPIMap

Organization Active NPI

Eastside Chiropractic Group a Professional Service Corporation

  • Chiropractor
  • Bellevue, WA
National Provider Identifier
1821433038
Registry record updated Jun 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH00003628 Issued in WA
Legal business name
EASTSIDE CHIROPRACTIC GROUP A PROFESSIONAL SERVICE CORPORATION
Practice address
1215 120TH Ave NE
Suite 100
Bellevue, WA 98005-2135
Phone
(425) 455-3300
Fax
(425) 455-3304
NPI assigned
May 1, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2013

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

Authorized official

Name
Dr. Keith McGahey, DCNPI 1861406704
Title
Chiropractor/Owner
Phone
(425) 455-3300

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 CH00003628 WA Primary

Addresses

Primary practice location

1215 120TH Ave NE
Suite 100
Bellevue, WA 98005-2135

Mailing address

1215 120TH Ave NE
Suite 100
Bellevue, WA 98005-2135
Phone (425) 455-3300

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130624000709 WA Part B Supplier - Clinic/Group Practice 5496994493 Receives reassigned benefits from 1 practitioner
Practice locations: Bellevue, WA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

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": "1367366400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1371081600000",
    "number": "1821433038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1215 120TH AVE NE",
            "address_2": "SUITE 100",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980052135",
            "telephone_number": "425-455-3300",
            "fax_number": "425-455-3304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 120TH AVE NE",
            "address_2": "SUITE 100",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980052135",
            "telephone_number": "425-455-3300",
            "fax_number": "425-455-3304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTSIDE CHIROPRACTIC GROUP A PROFESSIONAL SERVICE CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-01",
        "last_updated": "2013-06-13",
        "status": "A",
        "authorized_official_last_name": "MCGAHEY",
        "authorized_official_first_name": "KEITH",
        "authorized_official_title_or_position": "CHIROPRACTOR/OWNER",
        "authorized_official_telephone_number": "425-455-3300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH00003628",
            "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 13, 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.