Individual provider Active NPI

Richard Gordon Ward, D.C.

  • Chiropractor
  • Vancouver, WA
National Provider Identifier
1841337979
Registry record updated Jun 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH34275 Issued in WA
Practice address
1001 Broadway St Unit 200
Vancouver, WA 98660-3296
Phone
(360) 828-1574
NPI assigned
Jan 30, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH34275 WA Primary

Addresses

Primary practice location

1001 Broadway St Unit 200
Vancouver, WA 98660-3296

Mailing address

2625 Butterfield Rd Ste 301N
Oak Brook, IL 60523-1266
Phone (630) 468-1824

Other practice location 1

11803 101st Ave E
Suite 100
Puyallup, WA 98373-3473
Phone (253) 435-1285

Other identifiers 1

IdentifierTypeStateIssuer
0173766OtherWALABOR AND INDUSTRIES

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081028000201 WA Practitioner - Chiropractic 9830257393 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH34275WAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Michael B. Pettet, DC, PS Chiropractor Current Accepting new patients
Gig Harbor Wellness, PS CurrentSince Apr 3, 2019 Accepting new patients
Opdahl Chiropractic Office Inc. Chiropractor CurrentSince Jul 5, 2022 Accepting new patients
Bridge Chiropractic 5 LLC Chiropractor CurrentSince Jun 1, 2021 Accepting new patients

Locations

105 N Parkway Ave
Battle Ground, WA 98604
Phone (360) 666-6001

105 N Parkway Ave
Ste 101
Battle Ground, WA 98604
Phone (360) 666-6001

11430 51st Ave
Ste 101A
Gig Harbor, WA 98332
Phone (253) 857-6500

1001 Broadway St
Unit 200
Vancouver, WA 98660
Phone (360) 558-3365

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624233600000",
    "number": "1841337979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2625 BUTTERFIELD RD STE 301N",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231266",
            "telephone_number": "630-468-1824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 BROADWAY ST UNIT 200",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986603296",
            "telephone_number": "360-828-1574"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11803 101st Ave E",
            "address_2": "Suite 100",
            "address_purpose": "LOCATION",
            "city": "Puyallup",
            "state": "WA",
            "postal_code": "983733473",
            "country_code": "US",
            "telephone_number": "253-435-1285",
            "fax_number": "253-445-8632",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WARD",
        "first_name": "RICHARD",
        "middle_name": "GORDON",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-30",
        "last_updated": "2021-06-21",
        "certification_date": "2021-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH34275",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR AND INDUSTRIES",
            "identifier": "0173766",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2021; 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.