Individual provider Active NPI

Jeffery Don Treadway, D.C.

  • Chiropractor
  • Edmonds, WA
National Provider Identifier
1992841738
Registry record updated Nov 26, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH00002959 Issued in WA
Practice address
22727 Highway 99
Suite 109
Edmonds, WA 98026-8381
Phone
(425) 774-1090
Fax
(425) 775-9797
NPI assigned
Jan 29, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 26, 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 CH00002959 WA Primary

Addresses

Primary practice location

22727 Highway 99
Suite 109
Edmonds, WA 98026-8381

Mailing address

22727 Hwy 99
Suite 109
Edmonds, WA 98026-8381
Phone (425) 774-1090

Other identifiers 1

IdentifierTypeStateIssuer
CH00002959OtherWACHIROPRACTIC LICENSE NO.

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040420000635 WA Practitioner - Chiropractic 2062407778 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - West Sunnyvale, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bothell Chiropractic and Wellness, PLLCGroup PAC ID 3476607904, 2 clinicians

Practice addresses (Care Compare)

10024 Main St
Suite 2C
Bothell, WA 98011-3464
Phone (425) 485-1413

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Bothell Chiropractic & Wellness, PLLC CurrentSince Oct 20, 2018 Accepting new patients
Lifeplus Health Centers, PS Chiropractor CurrentSince Feb 1, 2015 Accepting new patients
Stephanie Greenall Chiropractor PastSince Feb 1, 2015 Accepting new patients

Locations

10024 Main St
Ste 2C
Bothell, WA 98011
Phone (425) 485-1413

6501 196th St SW
Ste C
Lynnwood, WA 98036
Phone (425) 775-2288

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": "1170028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196035200000",
    "number": "1992841738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22727 HWY 99",
            "address_2": "SUITE 109",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "980268381",
            "telephone_number": "425-774-1090",
            "fax_number": "425-775-9797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22727 HIGHWAY 99",
            "address_2": "SUITE 109",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "980268381",
            "telephone_number": "425-774-1090",
            "fax_number": "425-775-9797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TREADWAY",
        "first_name": "JEFFERY",
        "middle_name": "DON",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-29",
        "last_updated": "2007-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH00002959",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHIROPRACTIC LICENSE NO.",
            "identifier": "CH00002959",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Edmonds, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2007; 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.