Active NPI
Avery Neil Martin, D.C.
- Chiropractor
- Mount Vernon, WA
National Provider Identifier
1902967276
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 1315
- Practice address
- 22790 Buchanan Street
Mount Vernon, WA 98273 - Phone
- (360) 856-5562
- Fax
- (360) 856-4923
- NPI assigned
- Dec 12, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 1315 | WA | Primary |
Addresses
Primary practice location
22790 Buchanan Street
Mount Vernon, WA 98273
Mailing address
PO Box 508
Clearlake, WA 98235-0508
Phone (360) 856-5562
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1315 | WA | MD | Chiropractor |
Interoperability endpoints
- avery@cccp0008.direct.chirotouch.md
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165881600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1217894400000",
"number": "1902967276",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 508",
"city": "CLEARLAKE",
"state": "WA",
"postal_code": "982350508",
"telephone_number": "360-856-5562",
"fax_number": "360-856-4923"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "22790 BUCHANAN STREET",
"city": "MOUNT VERNON",
"state": "WA",
"postal_code": "98273",
"telephone_number": "360-856-5562",
"fax_number": "360-856-4923"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTIN",
"first_name": "AVERY",
"middle_name": "NEIL",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-12",
"last_updated": "2008-08-05",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "WA",
"license": "1315",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mount Vernon, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.