Individual provider Active NPI

Brian Kovara, D.C.

  • Chiropractor
  • Bainbridge Island, WA
National Provider Identifier
1942237102
Registry record updated Nov 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH60503164 Issued in WA
Practice address
363 Tormey LN NE
Suite 210
Bainbridge Island, WA 98110-2895
Phone
(206) 842-4929
Fax
(206) 842-4920
NPI assigned
Jun 26, 2006
Last updated
Nov 24, 2014By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 24, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3792-012 WI
Chiropractor 111N00000X CH60503164 WA Primary

Addresses

Primary practice location

363 Tormey LN NE
Suite 210
Bainbridge Island, WA 98110-2895

Mailing address

363 Tormey LN NE
Suite 210
Bainbridge Island, WA 98110-2895
Phone (206) 842-4929

Other identifiers 1

IdentifierTypeStateIssuer
38933700MedicaidWI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150623000515 WA Practitioner - Chiropractic 9032192349 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Northwestern College of Chiropractic, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

200 Winslow Way W
Unit 200
Bainbridge Island, WA 98110-4930
Phone (206) 842-4929

363 Tormey Lane
Suite 210
Bainbridge Island, WA 98110

363 Tormey LN NE
Suite 210
Bainbridge Island, WA 98110-1955

363 Tormey LN NE
Suite 210
Bainbridge Island, WA 98110-1957

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH60503164WAMDChiropractor
3792-012WIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Living Well Chiropractic & Massage Inc. Chiropractor CurrentSince Oct 1, 2014 Accepting new patients
Living Well Pain Clinics PLLC Chiropractor Past Accepting new patients
Chiropractic Company - Mke Downtown LTD Chiropractor Past Accepting new patients

Locations

200 Winslow Way W
Unit 200
Bainbridge Island, WA 98110
Phone (206) 842-4929

363 Tormey Ln NE
Ste 210
Bainbridge Island, WA 98110
Phone (206) 842-4929

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": "1151280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416787200000",
    "number": "1942237102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "363 TORMEY LN NE",
            "address_2": "SUITE 210",
            "city": "BAINBRIDGE ISLAND",
            "state": "WA",
            "postal_code": "981102895",
            "telephone_number": "206-842-4929",
            "fax_number": "206-842-4920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "363 TORMEY LN NE",
            "address_2": "SUITE 210",
            "city": "BAINBRIDGE ISLAND",
            "state": "WA",
            "postal_code": "981102895",
            "telephone_number": "206-842-4929",
            "fax_number": "206-842-4920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOVARA",
        "first_name": "BRIAN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-26",
        "last_updated": "2014-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "3792-012",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH60503164",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38933700",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bainbridge Island, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 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.