Individual provider Active NPI

Raymond Anthony Capone III, D.C.

  • Chiropractor
  • Portland, OR
National Provider Identifier
1023386851
Registry record updated Dec 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5020 Issued in OR
Practice address
2031 E Burnside St
Portland, OR 97214-1649
Phone
(503) 224-2100
Fax
(503) 224-2129
NPI assigned
Dec 7, 2011
Last updated
Dec 7, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 7, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 5020 OR Primary

Addresses

Primary practice location

2031 E Burnside St
Portland, OR 97214-1649

Mailing address

22020 NE Chinook Way
Apt B
Fairview, OR 97024-2701
Phone (412) 389-7811

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120523000328 OR Practitioner - Chiropractic 5092978429 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Portland Chiropractic Group Inc Chiropractor CurrentSince May 1, 2012 Accepting new patients

Locations

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1323216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323216000000",
    "number": "1023386851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22020 NE CHINOOK WAY",
            "address_2": "APT B",
            "city": "FAIRVIEW",
            "state": "OR",
            "postal_code": "970242701",
            "telephone_number": "412-389-7811"
        },
        {
            "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": "CAPONE",
        "first_name": "RAYMOND",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-12-07",
        "last_updated": "2011-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OR",
            "license": "5020",
            "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 Dec 7, 2011; 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.