Individual provider Active NPI

Jack Kieran Lindley, DC

  • Chiropractor
  • Tacoma, WA
National Provider Identifier
1972116184
Registry record updated Dec 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
61089046 Issued in WA
Practice address
4537 Yakima Ave
Tacoma, WA 98418-4929
Phone
(253) 475-3334
NPI assigned
Aug 27, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 61089046 WA Primary

Addresses

Primary practice location

4537 Yakima Ave
Tacoma, WA 98418-4929

Mailing address

4539 Olympus Loop
Gig Harbor, WA 98332-8069
Phone (360) 631-8313

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211227001030 WA Practitioner - Chiropractic 1658762794 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Western States College of Chiropractic, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

7901 Skansie Ave
Suite 145
Gig Harbor, WA 98335-8349
Phone (253) 358-6094

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
61089046WAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Crackyourbackjack, Inc. Chiropractor CurrentSince Feb 1, 2023 Accepting new patients
Still Well Chiropractic Clinic Inc Chiropractor PastSince Aug 30, 2020 Accepting new patients
Brent Finnigan LMP PastSince Aug 30, 2020 Accepting new patients

Locations

7901 Skansie Ave
Ste 145
Gig Harbor, WA 98335
Phone (253) 303-2328

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": "1598486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639267200000",
    "number": "1972116184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4539 OLYMPUS LOOP",
            "city": "GIG HARBOR",
            "state": "WA",
            "postal_code": "983328069",
            "telephone_number": "360-631-8313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4537 YAKIMA AVE",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984184929",
            "telephone_number": "253-475-3334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LINDLEY",
        "first_name": "JACK",
        "middle_name": "KIERAN",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-08-27",
        "last_updated": "2021-12-12",
        "certification_date": "2021-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "61089046",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2021; 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.