Individual provider Active NPI

Nathan Cokeley, D.C.

  • Chiropractor
  • Tigard, OR
National Provider Identifier
1073841003
Registry record updated Dec 2, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3972 Issued in OR
Practice address
11545 SW Durham Rd Ste B9
Tigard, OR 97224-3473
Phone
(503) 639-0778
NPI assigned
Dec 2, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 2, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3972 OR Primary

Addresses

Primary practice location

11545 SW Durham Rd Ste B9
Tigard, OR 97224-3473

Mailing address

11545 SW Durham Rd Ste B9
Tigard, OR 97224-3473
Phone (503) 639-0778

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091230000181 OR Practitioner - Chiropractic 9133269921 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Western States College of Chiropractic, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cornerstone Chiropractic LLCGroup PAC ID 4789572413, 3 clinicians

Practice addresses (Care Compare)

11565 SW Durham Rd
Suite 110
Tigard, OR 97224-3553
Phone (503) 639-0778

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Cornerstone Chiropractic, LLC Chiropractor CurrentSince Dec 17, 2009 Accepting new patients

Locations

11545 SW Durham Rd
Ste B9
Tigard, OR 97224
Phone (503) 624-7249

11565 SW Durham Rd
Ste 110
Tigard, OR 97224
Phone (503) 639-0774

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": "1259712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1259712000000",
    "number": "1073841003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11545 SW DURHAM RD STE B9",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972243473",
            "telephone_number": "503-639-0778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11545 SW DURHAM RD STE B9",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972243473",
            "telephone_number": "503-639-0778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COKELEY",
        "first_name": "NATHAN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-12-02",
        "last_updated": "2009-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OR",
            "license": "3972",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tigard, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2009; 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.