Individual provider Active NPI

John SWC Tuttle, DC

  • Chiropractor
  • Portland, OR
National Provider Identifier
1023194792
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
27 3304 Issued in OR
Practice address
4475 SW Scholls Ferry Rd
Ste 210
Portland, OR 97225-1955
Phone
(503) 292-0781
NPI assigned
Oct 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 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 27 3304 OR Primary

Addresses

Primary practice location

4475 SW Scholls Ferry Rd
Ste 210
Portland, OR 97225-1955

Mailing address

4475 SW Scholls Ferry Rd
Ste 210
Portland, OR 97225-1955
Phone (503) 292-0781

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040823000967 OR Practitioner - Chiropractic 2264406545 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
27 3304ORMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Chiropractic Center of Raleigh Hills PC Chiropractor CurrentSince Nov 20, 2018 Accepting new patients

Locations

4475 SW Scholls Ferry Rd
Ste 210
Portland, OR 97225
Phone (503) 245-2272

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": "1161907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1023194792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4475 SW SCHOLLS FERRY RD",
            "address_2": "STE 210",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972251955",
            "telephone_number": "503-292-0781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4475 SW SCHOLLS FERRY RD",
            "address_2": "STE 210",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972251955",
            "telephone_number": "503-292-0781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUTTLE",
        "first_name": "JOHN",
        "middle_name": "SWC",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OR",
            "license": "27 3304",
            "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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.