Individual provider Active NPI

Chad Roy Knowlden, LMP

  • Chiropractor
  • Vancouver, WA
National Provider Identifier
1952475352
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
MA00021977 Issued in WA
Practice address
2412 NE 138TH Ave Apt 73H
Vancouver, WA 98684-7258
Phone
(360) 892-2930
NPI assigned
Nov 17, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X MA00021977 WA Primary

Addresses

Primary practice location

2412 NE 138TH Ave Apt 73H
Vancouver, WA 98684-7258

Mailing address

2412 NE 138TH Ave Apt 73H
Vancouver, WA 98684-7258
Phone (360) 892-2930

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
MA00021977WAMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1952475352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2412 NE 138TH AVE APT 73H",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986847258",
            "telephone_number": "360-892-2930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2412 NE 138TH AVE APT 73H",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986847258",
            "telephone_number": "360-892-2930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNOWLDEN",
        "first_name": "CHAD",
        "middle_name": "ROY",
        "name_prefix": "Mr.",
        "credential": "LMP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "MA00021977",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jul 8, 2007; 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.