Individual provider Active NPI

Elise G. Hewitt, DC, CST, DICCP

  • Pediatric Chiropractor
  • Portland, OR
National Provider Identifier
1013017664
Registry record updated Jan 6, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric ChiropractorTaxonomy code 111NP0017X
License
2473 Issued in OR
Practice address
2031 E Burnside St
Portland, OR 97214-1649
Phone
(503) 224-2100
Fax
(503) 224-2129
NPI assigned
Sep 24, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Chiropractor 111NP0017X 2473 OR Primary

Addresses

Primary practice location

2031 E Burnside St
Portland, OR 97214-1649

Mailing address

2031 E Burnside St
Portland, OR 97214-1649
Phone (503) 224-2100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2473ORMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Portland Chiropractic Group Inc Pediatric Chiropractor PastSince Jan 20, 2011 Accepting new patients

Organizations & group practices 1

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": "1159056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1262736000000",
    "number": "1013017664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2031 E BURNSIDE ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972141649",
            "telephone_number": "503-224-2100",
            "fax_number": "503-224-2129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2031 E BURNSIDE ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972141649",
            "telephone_number": "503-224-2100",
            "fax_number": "503-224-2129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEWITT",
        "first_name": "ELISE",
        "middle_name": "G.",
        "name_prefix": "Dr.",
        "credential": "DC, CST, DICCP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-24",
        "last_updated": "2010-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NP0017X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Pediatric Chiropractor",
            "state": "OR",
            "license": "2473",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.