Individual provider Active NPI

Loriann McKellar, D.C.

  • Chiropractor
  • Vancouver, WA
National Provider Identifier
1912097361
Registry record updated Jan 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH00034673 Issued in WA
Practice address
12416 NW 36TH Ave
Vancouver, WA 98685-2225
Phone
(360) 574-9440
Fax
(360) 574-9288
NPI assigned
Oct 14, 2006
Last updated
Jan 4, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH00034673 WA Primary

Addresses

Primary practice location

12416 NW 36TH Ave
Vancouver, WA 98685-2225

Mailing address

12416 NW 36TH Ave
Vancouver, WA 98685-2225
Phone (360) 574-9440

Other identifiers 5

IdentifierTypeStateIssuer
0225697OtherWAL&I PAN
703832OtherWAACN PROVIDER ID
9478466OtherWAMULTIPLAN (PHCS) ID
8863691OtherWAMEDICARE GROUP PIN
885839001OtherWAREGENCE BC/BS OR

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070319000034 WA Practitioner - Chiropractic 7214030980 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

12416 NW 36TH Ave
Vancouver, WA 98685-2225
Phone (360) 574-9440

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH00034673WAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Natural Choice Chiropractic LLC Chiropractor CurrentSince Jan 2, 2007 Accepting new patients
Family Chiropractic at Salmon Creek Inc Chiropractor PastSince May 2, 2007 Accepting new patients
Beacon Chiropractic Co Chiropractor Past Accepting new patients

Locations

12416 NW 36th Ave
Vancouver, WA 98685
Phone (360) 574-9440

14313 NE 20th Ave
Ste A112
Vancouver, WA 98686
Phone (360) 574-9440

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1160784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704326400000",
    "number": "1912097361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12416 NW 36TH AVE",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986852225",
            "telephone_number": "360-574-9440",
            "fax_number": "360-574-9288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12416 NW 36TH AVE",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986852225",
            "telephone_number": "360-574-9440",
            "fax_number": "360-574-9288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKELLAR",
        "first_name": "LORIANN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-14",
        "last_updated": "2024-01-04",
        "certification_date": "2023-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH00034673",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I PAN",
            "identifier": "0225697",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ACN PROVIDER ID",
            "identifier": "703832",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MULTIPLAN (PHCS) ID",
            "identifier": "9478466",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP PIN",
            "identifier": "8863691",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BC/BS OR",
            "identifier": "885839001",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2024; 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.