Individual provider Active NPI

Cameron Keith Johnson, DC

  • Chiropractor
  • West Linn, OR
National Provider Identifier
1013248020
Registry record updated Jan 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3986 Issued in OR
Practice address
21400 Salamo Road
West Linn, OR 97068
Phone
(503) 650-2487
NPI assigned
Jan 15, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3986 OR Primary

Addresses

Primary practice location

21400 Salamo Road
West Linn, OR 97068

Mailing address

2232 NW Irving Street
Porland, OR 97210
Phone (503) 705-7477

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170220003030 OR Practitioner - Chiropractic 1456634344 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2009
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

22400 Salamo Rd
Suite 101
West Linn, OR 97068-8269
Phone (503) 650-2487

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3986ORMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Cameron Johnson DC LLC Chiropractor CurrentSince Jan 1, 2018 Accepting new patients
Summit Chiropractic Holding LLC Chiropractor Current Accepting new patients

Locations

21400 Salamo Rd
West Linn, OR 97068
Phone (503) 650-2487

22400 Salamo Rd
Ste 101
West Linn, OR 97068
Phone (503) 650-2487

Organizations & group practices 2

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": "1263513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1263513600000",
    "number": "1013248020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2232 NW IRVING STREET",
            "city": "PORLAND",
            "state": "OR",
            "postal_code": "97210",
            "telephone_number": "503-705-7477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21400 SALAMO ROAD",
            "city": "WEST LINN",
            "state": "OR",
            "postal_code": "97068",
            "telephone_number": "503-650-2487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "CAMERON",
        "middle_name": "KEITH",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-01-15",
        "last_updated": "2010-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OR",
            "license": "3986",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Linn, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2010; 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.