Individual provider Active NPI

Jonathan J Nordquist, DC

  • Chiropractor
  • Puyallup, WA
National Provider Identifier
1912922105
Registry record updated Sep 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH00034318 Issued in WA
Practice address
9909 168TH St E
102
Puyallup, WA 98373
Phone
(253) 445-3000
Fax
(253) 445-0301
NPI assigned
Jul 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH00034318 WA Primary

Addresses

Primary practice location

9909 168TH St E
102
Puyallup, WA 98373

Mailing address

9909 168TH St E
102
Puyallup, WA 98375-2513
Phone (253) 445-3000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050117000331 WA Practitioner - Chiropractic 5294797445 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nordquist Integrated MedicineGroup PAC ID 9234596156, 4 clinicians

Practice addresses (Care Compare)

9909 168TH St E
Suite 102
Puyallup, WA 98375-2513
Phone (253) 445-3000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH00034318WAMDChiropractor
45390TXMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Nordquist Integrated Medicine Chiropractor CurrentSince May 30, 2023 Accepting new patients
Durable Medical Equipment LLC CurrentSince May 22, 2020 Accepting new patients
L Paige Moomaw Chiropractor Past Accepting new patients

Locations

9909 168th St E
Ste 102
Puyallup, WA 98375
Phone (253) 445-3000

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1411948800000",
    "number": "1912922105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9909 168TH ST E",
            "address_2": "102",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983752513",
            "telephone_number": "253-445-3000",
            "fax_number": "253-445-0301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9909 168TH ST E",
            "address_2": "102",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "98373",
            "telephone_number": "253-445-3000",
            "fax_number": "253-445-0301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NORDQUIST",
        "first_name": "JONATHAN",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2014-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH00034318",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Puyallup, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2014; 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.