Organization Active NPI

Cedar Mill Family Chiropractic Inc

  • Chiropractor
  • Portland, OR
National Provider Identifier
1124790795
Registry record updated Oct 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
CEDAR MILL FAMILY CHIROPRACTIC INC
Practice address
12923 NW Cornell Rd Ste 201
Portland, OR 97229-5834
Phone
(503) 646-3393
NPI assigned
Oct 1, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2021

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

Authorized official

Name
Dr. Brandon Ryan Christy, DCNPI 1871047431
Title
President/Chiropractor
Phone
(541) 410-6776

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 Primary

Addresses

Primary practice location

12923 NW Cornell Rd Ste 201
Portland, OR 97229-5834

Mailing address

12923 NW Cornell Rd Ste 201
Portland, OR 97229-5834
Phone (503) 646-3393

Other names 1

  • Cedar Mill Chiropractic Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20211108001055 OR Part B Supplier - Clinic/Group Practice 1355730664 Receives reassigned benefits from 1 practitioner
Practice locations: Portland, OR

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": "1633046400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1635292800000",
    "number": "1124790795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12923 NW CORNELL RD STE 201",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972295834",
            "telephone_number": "503-646-3393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12923 NW CORNELL RD STE 201",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972295834",
            "telephone_number": "503-646-3393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CEDAR MILL FAMILY CHIROPRACTIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-01",
        "last_updated": "2021-10-27",
        "certification_date": "2021-10-27",
        "status": "A",
        "authorized_official_last_name": "CHRISTY",
        "authorized_official_first_name": "BRANDON",
        "authorized_official_middle_name": "RYAN",
        "authorized_official_title_or_position": "PRESIDENT/CHIROPRACTOR",
        "authorized_official_telephone_number": "541-410-6776",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cedar Mill Chiropractic Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Oct 27, 2021; 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.