Advanced Care PC
Organization Active NPI Chiropractor · Gresham, OR
NPI 1093984130 · NPPES record last updated Oct 6, 2015
Key facts
- NPI
- 1093984130
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Chiropractor 111N00000X
- License
- 27-2936 (OR)
- Legal business name
- ADVANCED CARE PC
- Practice address
- 837 E Powell Blvd
Gresham, OR 97030-7617 - Phone
- (503) 669-9495
- Fax
- (503) 669-8257
- NPI assigned
- Feb 22, 2008
- Organization subpart
- No
Authorized official
- Name
- Dr. Brian Vroom, D.C.
- Title
- Owner
- Phone
- (503) 358-1417
Practitioners 3
-
Brian Laurie Vroom, D.C.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OR
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20080516000100 | OR | Part B Supplier - Clinic/Group Practice | 9830268804 |
Receives reassigned benefits from 2 practitioners Practice locations: Gresham, OR |
National Provider Directory
Locations
837 E Powell Blvd
Gresham, OR 97030
Phone (503) 669-9495
Interoperability endpoints
- drvroom@accv0001.direct.chirotouch.md
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor |
111N00000X | 27-2936 | OR | Yes |
Addresses
Primary practice location
837 E Powell Blvd
Gresham, OR 97030-7617
Mailing address
837 E Powell Blvd
Gresham, OR 97030-7617
Phone (503) 669-9495
Other names
- Advanced Care Chiropractic
Other providers in Gresham, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 6, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.