Individual provider Active NPI

Susan Elizabeth Strom, D.C.

  • Chiropractor
  • Portland, OR
National Provider Identifier
1154312205
Registry record updated Oct 2, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
27 1461 Issued in OR
Practice address
2456 NW Northrup St
Suite 1-a
Portland, OR 97210-3253
Phone
(503) 223-6414
Fax
(503) 243-6632
NPI assigned
Oct 28, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 27 1461 OR Primary

Addresses

Primary practice location

2456 NW Northrup St
Suite 1-a
Portland, OR 97210-3253

Mailing address

2456 NW Northrup St
Suite 1-a
Portland, OR 97210-3253
Phone (503) 223-6414

Other names 1

  • Dr. Susan Strom Ray Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1461ORMDClinical Psychologist
27 1461ORMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1130457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191283200000",
    "number": "1154312205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2456 NW NORTHRUP ST",
            "address_2": "SUITE 1-A",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972103253",
            "telephone_number": "503-223-6414",
            "fax_number": "503-243-6632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2456 NW NORTHRUP ST",
            "address_2": "SUITE 1-A",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972103253",
            "telephone_number": "503-223-6414",
            "fax_number": "503-243-6632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STROM",
        "first_name": "SUSAN",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-28",
        "last_updated": "2007-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OR",
            "license": "27 1461",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUSAN",
            "last_name": "RAY",
            "middle_name": "STROM",
            "prefix": "DR.",
            "credential": "D.C.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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 2, 2007; 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.