Shady Cove Chiropractic, LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

SHADY COVE CHIROPRACTIC, LLC

Practice address

21885 Or-62
Shady Cove, OR 97539

Phone

(541) 878-3603

NPI assigned

Dec 3, 2021

Last updated

Dec 3, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Gina Eilertson, DCNPI 1093268286

Title

Owner/Chiropractor

Phone

(541) 282-4640

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Gina Eilertson, D.C.

  • Chiropractor
  • Shady Cove, OR
  • NPI 1093268286
  Medicare reassignment Care Compare group NPD Authorized official
• Robert Russell Bennett, D.C.

  • Chiropractor
  • Shady Cove, OR
  • NPI 1285786525
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1638489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1638489600000",
    "number": "1154089423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "832 MOUNTAIN VIEW DR",
            "city": "EAGLE POINT",
            "state": "OR",
            "postal_code": "975245616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21885 OR-62",
            "city": "SHADY COVE",
            "state": "OR",
            "postal_code": "97539",
            "telephone_number": "541-878-3603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHADY COVE CHIROPRACTIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-03",
        "last_updated": "2021-12-03",
        "certification_date": "2021-11-23",
        "status": "A",
        "authorized_official_last_name": "EILERTSON",
        "authorized_official_first_name": "GINA",
        "authorized_official_title_or_position": "OWNER/CHIROPRACTOR",
        "authorized_official_telephone_number": "541-282-4640",
        "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": []
}

• Optimal Behavioral Health
• Ryan Stuart Price, MA, LPC
• Kelsey Reed, RDH
• Rogue Community Health
• Shady Cove Chiropractic and Massage, LLC
• Shady Cove Family Dentistry
• Sisters of Providence in Oregon (PMG South Shady Cove)
• Shane Smedley, QMHA-R, CRM, PSS-AD
• Ann Marie Sprague, DPT
• Sarah Joyce Spriggs, LMT, BCTMB

• Chiropractor in Shady Cove, OR
• Providers in Shady Cove, OR by specialty
• Chiropractor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 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.