Gregory Atticus Mack, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

60677546 Issued in WA

Practice address

636 NW Richmond Beach Rd
Shoreline, WA 98177-3122

Phone

(206) 542-7571

Fax

(206) 546-1795

NPI assigned

Sep 6, 2016

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Specialty

Chiropractic

Education

Life Chiropractic College - West, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Paul a Mack DC PS IncGroup PAC ID 2264400118, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Paul a Mack DC PS Inc

  • Health Service Clinic/Center
  • Shoreline, WA
  • NPI 1740442193
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1473120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473120000000",
    "number": "1902353188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "636 NW RICHMOND BEACH RD",
            "city": "SHORELINE",
            "state": "WA",
            "postal_code": "981773122",
            "telephone_number": "206-542-7571",
            "fax_number": "206-546-1795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "636 NW RICHMOND BEACH RD",
            "city": "SHORELINE",
            "state": "WA",
            "postal_code": "981773122",
            "telephone_number": "206-542-7571",
            "fax_number": "206-546-1795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACK",
        "first_name": "GREGORY",
        "middle_name": "ATTICUS",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-09-06",
        "last_updated": "2016-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "60677546",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anne Lyons, PT
• Mary Ann Lyons, L.M.F.T., CMHS
• Grace Fuk Wai Ma
• Qianlu Ma
• Stephen Michael Macgeorge, DDS
• John William Mack, BA, CDP
• Paul A Mack, DC
• Laura Sheree Brunt Macleod, PHD
• Joy Mactavish-Unten, IBCLC, ICCE, CD, PCD
• Meghan Magone, MA

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2016; 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.