Individual provider Active NPI

David Pierce Hendrickson, D.C.

  • Chiropractor
  • Tacoma, WA
National Provider Identifier
1841379435
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Practice address
5015 Tacoma Mall Blvd
E 102
Tacoma, WA 98409-7107
Phone
(253) 472-4400
NPI assigned
Nov 3, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X WA Primary

Addresses

Primary practice location

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

Mailing address

34108 32ND Ave E
Eatonville, WA 98328-8236
Phone (253) 847-5729

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040213000408 WA Practitioner - Chiropractic 8426942962 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - West Sunnyvale, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
David Hendrickson D.C.PSGroup PAC ID 4284870098, 2 clinicians

Practice addresses (Care Compare)

5015 Tacoma Mall Blvd
Suite E102
Tacoma, WA 98409-7107
Phone (253) 472-4400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
601174975WAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
David Hendrickson D.C.PS Chiropractor CurrentSince May 1, 2013 Accepting new patients

Locations

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

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1162512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1841379435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34108 32ND AVE E",
            "city": "EATONVILLE",
            "state": "WA",
            "postal_code": "983288236",
            "telephone_number": "253-847-5729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5015 TACOMA MALL BLVD",
            "address_2": "E 102",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984097107",
            "telephone_number": "253-472-4400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDRICKSON",
        "first_name": "DAVID",
        "middle_name": "PIERCE",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.