Active NPI
Joseph Aaron Wisdom, DC
- Chiropractor
- Portland, OR
National Provider Identifier
1073262788
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 6212
- Practice address
- 2850 SE 82ND Ave Unit 10
Portland, OR 97266-1599 - Phone
- (503) 777-3000
- NPI assigned
- Mar 21, 2022
- Last updated
- Mar 21, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 6212 | OR | Primary |
Addresses
Primary practice location
2850 SE 82ND Ave Unit 10
Portland, OR 97266-1599
Mailing address
3132 SW Marigold St Apt 12
Portland, OR 97219-5381
Phone (714) 200-6027
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
| License | State | Type | Specialty |
|---|---|---|---|
| 6212 | OR | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1647820800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1647820800000",
"number": "1073262788",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3132 SW MARIGOLD ST APT 12",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972195381",
"telephone_number": "714-200-6027"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2850 SE 82ND AVE UNIT 10",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972661599",
"telephone_number": "503-777-3000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WISDOM",
"first_name": "JOSEPH",
"middle_name": "AARON",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-03-21",
"last_updated": "2022-03-21",
"certification_date": "2022-03-21",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "OR",
"license": "6212",
"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 Mar 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.