Individual provider Active NPI

Anita Louise Leblanc, D.C.

  • Chiropractor
  • Bellevue, WA
National Provider Identifier
1861762395
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH60389093 Issued in WA
Practice address
606 120TH Ave NE Building D Ste 100
Bellevue, WA 98005-3024
Phone
(425) 688-0223
Fax
(425) 688-0323
NPI assigned
Dec 30, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH60389093 WA Primary
Chiropractor 111N00000X 5022 OR

Addresses

Primary practice location

606 120TH Ave NE Building D Ste 100
Bellevue, WA 98005-3024

Mailing address

15 SW Everett Mall Way Ste G
Everett, WA 98204-2715
Phone (425) 355-5222

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140828000410 WA Practitioner - Chiropractic 8921226200 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Western States College of Chiropractic, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Functional Health Consulting LLCGroup PAC ID 1759560709, 36 clinicians

Practice addresses (Care Compare)

606 120TH Ave NE
Suite D100
Bellevue, WA 98005-3026
Phone (425) 688-0223

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH60389093WAMDChiropractor
5022ORMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Functional Health Consulting, LLC Current Accepting new patients
Functional Health Consulting, LLC Chiropractor CurrentSince Mar 25, 2018 Accepting new patients
Functional Health Consulting, LLC Chiropractor CurrentSince Mar 25, 2018 Accepting new patients
NW Sports Rehab, Corp. Chiropractor CurrentSince Aug 1, 2014 Accepting new patients
Functional Health Consulting, LLC Past Accepting new patients

Locations

606 120th Ave NE
Ste D100
Bellevue, WA 98005
Phone (425) 688-0223

606 120th Ave NE
Ste 100
Bellevue, WA 98005
Phone (425) 688-0223

15 SW Everett Mall Way
Ste G
Everett, WA 98204
Phone (425) 355-5222

33400 13th Pl S
Federal Way, WA 98003
Phone (253) 838-6070

2014 E Madison St
Ste 100
Seattle, WA 98122
Phone (206) 726-9551

Organizations & group practices 5

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": "1325203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1861762395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 SW EVERETT MALL WAY STE G",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982042715",
            "telephone_number": "425-355-5222",
            "fax_number": "425-355-5231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "606 120TH AVE NE BUILDING D STE 100",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980053024",
            "telephone_number": "425-688-0223",
            "fax_number": "425-688-0323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEBLANC",
        "first_name": "ANITA",
        "middle_name": "LOUISE",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-12-30",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH60389093",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OR",
            "license": "5022",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.