1. Home
  2. Directory
  3. Washington
  4. Bainbridge Island
  5. Chiropractor
  6. NPI Profile

KIRK W PETHERAM D.C.
NPI 1770613580
Chiropractor in Bainbridge Island, WA

Active since March 07, 2007
701 WINSLOW WAY E STE B, BAINBRIDGE ISLAND, WA 98110(206) 842-2702 Get Directions Write a Review

NPPES record last updated: January 12, 2012. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Kirk W Petheram D.c. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KIRK W PETHERAM D.C. (NPI 1770613580) is an individual chiropractor in Bainbridge Island, Washington, licensed in Washington (3554) and active in the NPI registry since March 2007. He is a graduate of Other (1992).

NPPES Registry Identity

NPI1770613580
Entity TypeIndividualMale
Primary Taxonomy111N00000X
Provider Legal NameKIRK W PETHERAMCredential: D.C.
Location Address701 WINSLOW WAY E STE BBainbridge Island, WA 98110-2416
Mailing Address701 Winslow Way E Ste BBainbridge Island, WA 98110-2416 · (206) 842-2702
Phone(206) 842-2702
Sole ProprietorYes
Medical School CMSOtherGraduated 1992
Enumeration DateMarch 7, 2007
Last NPPES UpdateJanuary 12, 2012
✔ NPI 1770613580 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyChiropractorChiropractic Providers
Taxonomy Code111N00000X
Licenses✔ Licensed in WA · 3554✔ Licensed in CA · 22433
Definition
A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.
701 WINSLOW WAY E STE B, Bainbridge Island, WA 98110
Open in Google Maps ↗

Other Identifiers 1

Medicare ID-Type UnspecifiedGAB34482WA

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Premera Blue Cross Blue Shield of Alaska, Providence Health Plan.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kirk W Petheram D.c. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID3173413598
PECOS Enrollment IDI20120229000189

Medicare Billing Reassignments

2

Medicare enrollment records show Kirk Petheram reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Eagle Harbor Health & Chiropractic
45 mi
Chiropractor
2405 EVERGREEN PARK DR SW STE B1
Olympia, WA 98502
  • Reassigned Medicare billing, Washington enrollment
NPI 1881964419 (206) 842-2690
Anthony Rodriguez Dc PLLC
48 mi
Chiropractor
1518 BISHOP RD SW
Tumwater, WA 98512
  • Reassigned Medicare billing, Washington enrollment
  • 3 clinicians in this Medicare group
NPI 1699242982 (360) 923-5588

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Chiropractic manipulative treatment, 3-4 spinal regions 98941
Chiropractic manipulative treatment for 3-4 spinal regions involves a trained professional applying controlled force to specific areas of your spine. This can help alleviate pain, improve physical function, and support your body's natural healing process.
729 services78 patients
Chiropractic manipulative treatment, 1-2 spinal regions 98940
Chiropractic manipulative treatment focuses on adjusting your spine to improve your body's physical function. In this service, a chiropractor applies controlled force to 1-2 spinal regions. This helps to restore mobility and alleviate discomfort in those areas.
52 services14 patients

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

AMBER LYNNE ADLER LMT
Massage Therapist
701 WINSLOW WAY E STE B
BAINBRIDGE ISLAND, WA 98110
Kitsap County (206) 451-4304
SHELLEY BLAIN REIMER LMT
Massage Therapist
701 WINSLOW WAY E STE B
BAINBRIDGE ISLAND, WA 98110
Kitsap County (206) 842-2702
YEVGENIA M ZENICK
Massage Therapist
701 WINSLOW WAY E STE B
BAINBRIDGE ISLAND, WA 98110
Kitsap County (206) 451-4304
JOHNNI JULIA CASSIDY LMP
Massage Therapist
701 WINSLOW WAY E STE B
BAINBRIDGE ISLAND, WA 98110
Kitsap County (206) 842-2690
MS. AMY BETH SINGH LMT
Massage Therapist
701 WINSLOW WAY E STE B
BAINBRIDGE ISLAND, WA 98110
Kitsap County (206) 842-2690
JOY LYN KAMRIN
Massage Therapist
701 WINSLOW WAY E STE B
BAINBRIDGE ISLAND, WA 98110
Kitsap County (206) 842-2690

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kirk Petheram's NPI number?

The NPI number for Kirk Petheram is 1770613580. It was assigned to this individual provider in the NPPES registry on March 7, 2007.

Where is Kirk Petheram located?

Kirk Petheram practices at 701 Winslow Way E Ste B, Bainbridge Island, WA 98110. The listed phone number is (206) 842-2702.

What is Kirk Petheram's specialty?

The primary specialty registered for this NPI is Chiropractor with taxonomy code 111N00000X.

Is Kirk Petheram enrolled in Medicare?

Yes. Kirk Petheram is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Kirk Petheram's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kirk Petheram reassigns Medicare benefits to 2 organizations: Eagle Harbor Health & Chiropractic (Olympia, WA) and Anthony Rodriguez Dc PLLC (Tumwater, WA). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kirk Petheram's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Kirk Petheram accept?

Health plans from Premera Blue Cross Blue Shield of Alaska and Providence Health Plan list Kirk Petheram as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Kirk Petheram was last updated on January 12, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.