NPIMap

Organization Active NPI

Newberg Spine and Sport LLC

  • Chiropractor
  • Newberg, OR
National Provider Identifier
1083133193
Registry record updated Sep 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5127 Issued in OR
Legal business name
NEWBERG SPINE AND SPORT LLC
Practice address
2504 Portland Rd Ste a
Newberg, OR 97132-1971
Phone
(503) 538-9119
NPI assigned
Sep 11, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2017

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

Authorized official

Name
Chad MooreNPI 1699015982
Title
Owner
Phone
(503) 538-9119

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 5127 OR Primary

Addresses

Primary practice location

2504 Portland Rd Ste a
Newberg, OR 97132-1971

Mailing address

2504 Portland Rd Ste a
Newberg, OR 97132-1971

Other names 1

  • Dundee Chiropractic Clinic Former legal business name

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1505088000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1505088000000",
    "number": "1083133193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2504 PORTLAND RD STE A",
            "city": "NEWBERG",
            "state": "OR",
            "postal_code": "971321971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2504 PORTLAND RD STE A",
            "city": "NEWBERG",
            "state": "OR",
            "postal_code": "971321971",
            "telephone_number": "503-538-9119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEWBERG SPINE AND SPORT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-11",
        "last_updated": "2017-09-11",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "CHAD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-538-9119"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "OR",
            "license": "5127",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dundee Chiropractic Clinic",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Newberg, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.