NPIMap

Organization Active NPI

Back to Action Chiropractic LLC

  • Chiropractor
  • Mountlake Terrace, WA
National Provider Identifier
1851571772
Registry record updated Feb 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH00002267 Issued in WA
Legal business name
BACK TO ACTION CHIROPRACTIC LLC
Practice address
6603 220TH St SW
Ste 100
Mountlake Terrace, WA 98043
Phone
(425) 670-2600
Fax
(425) 778-7073
NPI assigned
Nov 8, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2008

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

Authorized official

Name
Jerry B Dreessen, DC
Title
Owner
Phone
(425) 670-2600

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X CH00002267 WA Primary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X CH00034001 WA

Addresses

Primary practice location

6603 220TH St SW
Ste 100
Mountlake Terrace, WA 98043

Mailing address

6603 220TH St SW
Ste 100
Mountlake Terrace, WA 98043
Phone (425) 670-2600

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080324000037 WA Part B Supplier - Clinic/Group Practice 6901982578 Receives reassigned benefits from 1 practitioner
Practice locations: Mountlake Terrace, WA

National Provider Directory

National Provider Directory

Locations

6603 220th St SW
Ste 100
Mountlake Terrace, WA 98043
Phone (425) 670-2600

Practitioners & affiliated clinicians

Practitioners 9

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": "1194480000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1203465600000",
    "number": "1851571772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6603 220TH ST SW",
            "address_2": "STE 100",
            "city": "MOUNTLAKE TERRACE",
            "state": "WA",
            "postal_code": "98043",
            "telephone_number": "425-670-2600",
            "fax_number": "425-778-7073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6603 220TH ST SW",
            "address_2": "STE 100",
            "city": "MOUNTLAKE TERRACE",
            "state": "WA",
            "postal_code": "98043",
            "telephone_number": "425-670-2600",
            "fax_number": "425-778-7073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BACK TO ACTION CHIROPRACTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-08",
        "last_updated": "2008-02-20",
        "status": "A",
        "authorized_official_last_name": "DREESSEN",
        "authorized_official_first_name": "JERRY",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "425-670-2600",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH00002267",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH00034001",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mountlake Terrace, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 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.