KIRK W PETHERAM (D.C.) – Chiropractor, NPI 1770613580

KIRK W PETHERAM (D.C.) is a healthcare provider. based in Bainbridge island, Washington. specializing in CHIROPRACTIC. They hold the professional credentials D.C.. They hold a License No. 3554 (WA). The NPI Number for KIRK W PETHERAM (D.C.) is 1770613580

Main info

Male
Sole Proprietor
34 Years Of Experience
Accepts Medicare Assignment
Name
KIRK W PETHERAM (D.C.)
NPI
1770613580
Phone
(206) 842-2702
Address
701 WINSLOW WAY E STE B
Enumeration Date
7 March 2007
Last Update Date
12 January 2012

Doctor Profile

Medical School Name
OTHER
Secondary Phone
-
Graduation Year
1992 (34 years ago)
PAC ID
3173413598
Professional Enrollment ID
I20120229000189
Address ID
WA981102823BA931XXNEXX401
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience61
Completeness75
Years active:19State licenses:2Digital endpointsOther names

1,415 CHIROPRACTIC in WA

Provider Addresses for KIRK W PETHERAM (D.C.)

  • 701 WINSLOW WAY E STE B

    BAINBRIDGE ISLAND, WA 981102416

    Phone: (206) 842-2702

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2012-02-29

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20120229000189IChiropracticWATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
98941Chiropractic manipulative treatment, 3-4 spinal regions55172$0
98940Chiropractic manipulative treatment, 1-2 spinal regions10419$0
View full utilization report →

Insurance plans in this area (ZIP 98110)

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Reviews

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Frequently asked questions

Does KIRK W PETHERAM (D.C.) share an NPI with anyone else?
NPI numbers are unique to each provider or organization — KIRK W PETHERAM (D.C.) uses 1770613580.
Does the file indicate KIRK W PETHERAM (D.C.) is practicing under active NPI?
Directory data currently reports KIRK W PETHERAM (D.C.) as active.
What is KIRK W PETHERAM (D.C.)'s specialty?
The listing groups KIRK W PETHERAM (D.C.) with Chiropractor. Clinical services aligned with this taxonomy classification.
Does KIRK W PETHERAM (D.C.) list a practice location?
Patients near Bainbridge Island, Washington may find KIRK W PETHERAM (D.C.) in results; validate coverage separately.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.