Organization Active NPI

Wise Chiropractic, LLC

  • Chiropractor
  • Portland, OR
National Provider Identifier
1104600113
Registry record updated Aug 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
WISE CHIROPRACTIC, LLC
Practice address
522 NW 12TH Ave
Portland, OR 97209-3001
Phone
(503) 227-2886
Fax
(503) 790-1004
NPI assigned
Aug 21, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2023

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

Authorized official

Name
Dr. Nicholas Alexander Wise, D.C.NPI 1194784140
Title
Owner
Phone
(971) 864-1972

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: 193200000X MULTI-SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

522 NW 12TH Ave
Portland, OR 97209-3001

Mailing address

522 NW 12TH Ave
Portland, OR 97209-3001
Phone (503) 227-2886

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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": "1692576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692576000000",
    "number": "1104600113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "522 NW 12TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972093001",
            "telephone_number": "503-227-2886",
            "fax_number": "503-790-1004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "522 NW 12TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972093001",
            "telephone_number": "503-227-2886",
            "fax_number": "503-790-1004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WISE CHIROPRACTIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-21",
        "last_updated": "2023-08-21",
        "certification_date": "2023-08-21",
        "status": "A",
        "authorized_official_last_name": "WISE",
        "authorized_official_first_name": "NICHOLAS",
        "authorized_official_middle_name": "ALEXANDER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "971-864-1972",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "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 Aug 21, 2023; 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.