NPIMap

Organization Active NPI

Premier Chiropractic 5 PLLC

  • Chiropractor
  • Seattle, WA
National Provider Identifier
1851583348
Registry record updated Jul 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH00034182 Issued in WA
Legal business name
PREMIER CHIROPRACTIC 5 PLLC
Practice address
6415 Fauntleroy Way SW
Seattle, WA 98136-1871
Phone
(206) 938-2285
Fax
(206) 938-4219
NPI assigned
Aug 17, 2007
Organization subpart
Yes
Parent organization
PREMIER CHIROPRACTIC & MASSAGEAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 11, 2008

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

Authorized official

Name
Lilly Hansen
Title
Office Manager
Phone
(425) 614-4000

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X CH00034182 WA Primary
Massage TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225700000X MA00021456 WA

Addresses

Primary practice location

6415 Fauntleroy Way SW
Seattle, WA 98136-1871

Mailing address

6415 Fauntleroy Way SW
Seattle, WA 98136-1871
Phone (206) 938-2285

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060202000496 WA Part B Supplier - Clinic/Group Practice 0648284273 Receives reassigned benefits from 1 practitioner
Practice locations: Seattle, WA

National Provider Directory

National Provider Directory
Tax ID family
Conscious Choice Chiropractic2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the 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": "1187308800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215734400000",
    "number": "1851583348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6415 FAUNTLEROY WAY SW",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981361871",
            "telephone_number": "206-938-2285",
            "fax_number": "206-938-4219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6415 FAUNTLEROY WAY SW",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981361871",
            "telephone_number": "206-938-2285",
            "fax_number": "206-938-4219"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER CHIROPRACTIC 5 PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PREMIER CHIROPRACTIC & MASSAGE",
        "enumeration_date": "2007-08-17",
        "last_updated": "2008-07-11",
        "status": "A",
        "authorized_official_last_name": "HANSEN",
        "authorized_official_first_name": "LILLY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "425-614-4000"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH00034182",
            "primary": true
        },
        {
            "code": "225700000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA00021456",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 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.