Troy D. Eldridge Sr., D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

025202 CH00003217 Issued in WA

Practice address

18 W. 1St Avenue
Odessa, WA 99159

Phone

(509) 982-2880

NPI assigned

Jan 11, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Ovenell Chiropractic PS

  • Chiropractor
  • East Wenatchee, WA
  • NPI 1649459090
  Medicare reassignment NPD

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

{
    "created_epoch": "1168473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190592000000",
    "number": "1891845046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 560",
            "city": "ODESSA",
            "state": "WA",
            "postal_code": "991590560",
            "telephone_number": "509-982-2880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 W. 1ST AVENUE",
            "city": "ODESSA",
            "state": "WA",
            "postal_code": "99159",
            "telephone_number": "509-982-2880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELDRIDGE",
        "first_name": "TROY",
        "middle_name": "D.",
        "name_prefix": "Dr.",
        "name_suffix": "Sr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-11",
        "last_updated": "2007-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "025202 CH00003217",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR & INDUSTRIES",
            "identifier": "106781",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2021327",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marlene K Brendell, ARNP
• Condon Dental Services
• James T. Dedeaux Jr., MSW
• Eldridge Chiropractic PS
• Deborah A Fogg, NP
• Daniel Glaze, ARNP
• Gregg Liedtka DMD PLLC
• Lincoln County Public Hospital District 1
• Lincoln County Public Hospital District 1

• Chiropractor in Odessa, WA
• Providers in Odessa, WA by specialty
• Chiropractor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2007; 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.