NPIMap

Organization Active NPI

Chittenden Chiropractic PS

  • Chiropractor
  • Lakewood, WA
National Provider Identifier
1831496314
Registry record updated Apr 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2148 Issued in WA
Legal business name
CHITTENDEN CHIROPRACTIC PS
Practice address
8905 Gravelly Lake Dr SW
Lakewood, WA 98499-3109
Phone
(253) 581-1533
Fax
(253) 588-2145
NPI assigned
Feb 18, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2011

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

Authorized official

Name
Dr. Stephen John Chittenden, D.C.NPI 1487748372
Title
President
Phone
(253) 581-1533

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 2148 WA Primary

Addresses

Primary practice location

8905 Gravelly Lake Dr SW
Lakewood, WA 98499-3109

Mailing address

8905 Gravelly Lake Dr SW
Lakewood, WA 98499-3109
Phone (253) 581-1533

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110427000592 WA Part B Supplier - Clinic/Group Practice 2668657180 Receives reassigned benefits from 1 practitioner
Practice locations: Lakewood, WA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1297987200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1303948800000",
    "number": "1831496314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8905 GRAVELLY LAKE DR SW",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984993109",
            "telephone_number": "253-581-1533",
            "fax_number": "253-588-2145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8905 GRAVELLY LAKE DR SW",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984993109",
            "telephone_number": "253-581-1533",
            "fax_number": "253-588-2145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHITTENDEN CHIROPRACTIC PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-18",
        "last_updated": "2011-04-28",
        "status": "A",
        "authorized_official_last_name": "CHITTENDEN",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "253-581-1533",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "2148",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2011; 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.