Organization Active NPI

Holbrook Enterprise Inc.

  • Chiropractor
  • Bend, OR
National Provider Identifier
1104271063
Registry record updated Mar 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3750 Issued in OR
Legal business name
HOLBROOK ENTERPRISE INC.
Practice address
598 NW Hill St Ste B
Bend, OR 97703-2970
Phone
(541) 989-9373
NPI assigned
Apr 28, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2019

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

Authorized official

Name
Dr. Jeremy Scott Holbrook, DCNPI 1720287808
Title
President
Phone
(541) 639-5389

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 3750 OR Primary

Addresses

Primary practice location

598 NW Hill St Ste B
Bend, OR 97703-2970

Mailing address

598 NW Hill St Ste B
Bend, OR 97703-2970
Phone (541) 639-5389

Other names 1

  • Bend Healing Chiropractic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20161118000544 OR Part B Supplier - Clinic/Group Practice 3375822158 Receives reassigned benefits from 1 practitioner
Practice locations: Bend, OR

National Provider Directory

National Provider Directory

Locations

598 NW Hill St
Ste B
Bend, OR 97703
Phone (541) 385-7688

Practitioners & affiliated clinicians

Practitioners 2

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": "1461801600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1552348800000",
    "number": "1104271063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "598 NW HILL ST STE B",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977032970",
            "telephone_number": "541-639-5389",
            "fax_number": "855-300-5358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "598 NW HILL ST STE B",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977032970",
            "telephone_number": "541-989-9373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLBROOK ENTERPRISE INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-28",
        "last_updated": "2019-03-12",
        "status": "A",
        "authorized_official_last_name": "HOLBROOK",
        "authorized_official_first_name": "JEREMY",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "541-639-5389",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "OR",
            "license": "3750",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bend Healing Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bend, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2019; 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.