Proactive Health Chiropractic, Corp

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CH 60570733 Issued in WA

Legal business name

PROACTIVE HEALTH CHIROPRACTIC, CORP

Practice address

23801 E Appleway Ave
110
Liberty Lake, WA 99019-9687

Phone

(507) 251-5248

NPI assigned

Jun 22, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Samuel Nelson, D.C.NPI 1215393079

Title

President

Phone

(507) 251-5248

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Samuel Lionel Nelson, D.C.

  • Chiropractor
  • Colorado Springs, CO
  • NPI 1215393079
  NPD Authorized official

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

{
    "created_epoch": "1434931200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1434931200000",
    "number": "1922480383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4915 N VISTA GRANDE DR",
            "city": "OTIS ORCHARDS",
            "state": "WA",
            "postal_code": "990275001",
            "telephone_number": "507-251-5248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23801 E APPLEWAY AVE",
            "address_2": "110",
            "city": "LIBERTY LAKE",
            "state": "WA",
            "postal_code": "990199687",
            "telephone_number": "507-251-5248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROACTIVE HEALTH CHIROPRACTIC, CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-22",
        "last_updated": "2015-06-22",
        "status": "A",
        "authorized_official_last_name": "NELSON",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "507-251-5248",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH 60570733",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tyler Peterson Peterson
• Jacklyn Rose Petretee
• Heather Pincelli
• Cheralee K Pinnock, LMP
• Hazel Floranda Porter, RPH
• Cyndi Rai, LMP
• Scott Ralph, D.D.S., M.S.
• Erin Ralston, RN
• Catrina Lillian Richards, LMT
• Nicole Elizabeth Rippee, MC 61510113

• Chiropractor in Liberty Lake, WA
• Providers in Liberty Lake, WA by specialty
• Chiropractor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.