NPIMap

Organization Active NPI

Thomas Wayne PLLC

Doing business as Overlake Chiropractic Clinic

  • Chiropractor
  • Burien, WA
National Provider Identifier
1962694224
Registry record updated May 29, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH00034652 Issued in WA
Legal business name
THOMAS WAYNE PLLC
Doing business as
Overlake Chiropractic Clinic
Practice address
15858 1St Avenue South
Suite #A104
Burien, WA 98148
Phone
(206) 838-0022
Fax
(206) 838-0021
NPI assigned
Aug 10, 2007
Last updated
May 29, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 29, 2013

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

Authorized official

Name
Dr. Kevin Wayne Manchester, D.C.NPI 1245258854
Title
Doctor/Owner
Phone
(206) 838-0022

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X CH00034652 WA Primary

Addresses

Primary practice location

15858 1St Avenue South
Suite #A104
Burien, WA 98148

Mailing address

15858 1St Avenue South
Suite #A104
Burien, WA 98148
Phone (206) 838-0022

Other names 1

  • Overlake Chiropractic Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071221000522 WA Part B Supplier - Clinic/Group Practice 7416047808 Receives reassigned benefits from 1 practitioner
Practice locations: Burien, WA

National Provider Directory

National Provider Directory

Locations

15858 1st Ave S
Ste A104
Burien, WA 98148
Phone (206) 838-0022

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1186704000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1369785600000",
    "number": "1962694224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15858 1ST AVENUE SOUTH",
            "address_2": "SUITE #A104",
            "city": "BURIEN",
            "state": "WA",
            "postal_code": "98148",
            "telephone_number": "206-838-0022",
            "fax_number": "206-838-0021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15858 1ST AVENUE SOUTH",
            "address_2": "SUITE #A104",
            "city": "BURIEN",
            "state": "WA",
            "postal_code": "98148",
            "telephone_number": "206-838-0022",
            "fax_number": "206-838-0021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THOMAS WAYNE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-10",
        "last_updated": "2013-05-29",
        "status": "A",
        "authorized_official_last_name": "MANCHESTER",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "DOCTOR/OWNER",
        "authorized_official_telephone_number": "206-838-0022",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH00034652",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Overlake Chiropractic Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Burien, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.