Individual provider Active NPI

David Wayne Stedman, DC

  • Chiropractor
  • Silverdale, WA
National Provider Identifier
1891865630
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH00001522 Issued in WA
Practice address
3595 NW Bucklin Hill Rd
Silverdale, WA 98383
Phone
(360) 698-3140
Fax
(360) 692-1441
NPI assigned
Nov 9, 2006
Sex
Male
Sole proprietor
No

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 CH00001522 WA Primary

Addresses

Primary practice location

3595 NW Bucklin Hill Rd
Silverdale, WA 98383

Mailing address

PO Box 483
Silverdale, WA 98383
Phone (360) 698-3140

Other identifiers 3

IdentifierTypeStateIssuer
54151OtherWALABOR & INDUSTRY
91118703302OtherWAKITSAP PHYSICIANS SERVICE
203760203760OtherWAPREMERA BLUE CROSS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101129000379 WA Practitioner - Chiropractic 6305736885 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Northwestern College of Chiropractic, 1979
Medicare assignment
May accept Medicare assignment
Group practices
The Chiropractors Clinic PSGroup PAC ID 3870483357, 2 clinicians

Practice addresses (Care Compare)

3595 NW Bucklin Hill Rd
Silverdale, WA 98383-8503
Phone (360) 698-3140

PO Box
Suite 483
Silverdale, WA 98383-0483

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH00001522WAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
The Chiropractors Clinic, P.S. Chiropractor CurrentSince Apr 15, 2002 Accepting new patients
Kitsap Medical Supply, LLC CurrentSince May 17, 2020 Accepting new patients

Locations

3595 NW Bucklin Hill Rd
Silverdale, WA 98383
Phone (360) 698-3140

Organizations & group practices 2

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": "1163030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1891865630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 483",
            "city": "SILVERDALE",
            "state": "WA",
            "postal_code": "98383",
            "telephone_number": "360-698-3140",
            "fax_number": "360-692-1441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3595 NW BUCKLIN HILL RD",
            "city": "SILVERDALE",
            "state": "WA",
            "postal_code": "98383",
            "telephone_number": "360-698-3140",
            "fax_number": "360-692-1441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEDMAN",
        "first_name": "DAVID",
        "middle_name": "WAYNE",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH00001522",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR & INDUSTRY",
            "identifier": "54151",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KITSAP PHYSICIANS SERVICE",
            "identifier": "91118703302",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREMERA BLUE CROSS",
            "identifier": "203760203760",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Silverdale, 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.