NPIMap

Organization Active NPI

Skagit River Chiropractic PS Inc

  • Chiropractor
  • Burlington, WA
National Provider Identifier
1982825618
Registry record updated Feb 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
070238750 Issued in WA
Legal business name
SKAGIT RIVER CHIROPRACTIC PS INC
Practice address
830 E Fairhaven Ave
Burlington, WA 98233-1917
Phone
(360) 757-7373
Fax
(360) 757-6369
NPI assigned
May 1, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2012

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

Authorized official

Name
Jason Ronald Kitzman, D.C.NPI 1215022900
Title
Owner
Phone
(360) 757-7373

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 MULTIPLE SINGLE SPECIALTY GROUP 111N00000X 070238750 WA Primary

Addresses

Primary practice location

830 E Fairhaven Ave
Burlington, WA 98233-1917

Mailing address

830 E Fairhaven Ave
Burlington, WA 98233-1917
Phone (360) 757-7373

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031212000843 WA Part B Supplier - Clinic/Group Practice 8224935887 Receives reassigned benefits from 2 practitioners
Practice locations: Burlington, WA

National Provider Directory

National Provider Directory

Locations

830 E Fairhaven Ave
Burlington, WA 98233
Phone (360) 757-6369

Practitioners & affiliated clinicians

Practitioners 11

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

NPI Registry JSON

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

{
    "created_epoch": "1177977600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1330300800000",
    "number": "1982825618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "830 E FAIRHAVEN AVE",
            "city": "BURLINGTON",
            "state": "WA",
            "postal_code": "982331917",
            "telephone_number": "360-757-7373",
            "fax_number": "360-757-6369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 E FAIRHAVEN AVE",
            "city": "BURLINGTON",
            "state": "WA",
            "postal_code": "982331917",
            "telephone_number": "360-757-7373",
            "fax_number": "360-757-6369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SKAGIT RIVER CHIROPRACTIC PS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-01",
        "last_updated": "2012-02-27",
        "status": "A",
        "authorized_official_last_name": "KITZMAN",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "RONALD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "360-757-7373",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "070238750",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlington, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2012; 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.