NPIMap

Organization Active NPI

Falling Waters LLC

  • Chiropractor
  • Bend, OR
National Provider Identifier
1154449890
Registry record updated Jun 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
FALLING WATERS LLC
Practice address
55 NW Wall St Ste 100
Bend, OR 97703-3200
Phone
(541) 389-4321
Fax
(541) 389-4420
NPI assigned
Mar 27, 2007
Last updated
Jun 8, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2021

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

Authorized official

Name
Dr. David McClintock, DCNPI 1972004877
Title
Managing Member
Phone
(541) 389-4321

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

55 NW Wall St Ste 100
Bend, OR 97703-3200

Mailing address

55 NW Wall St Ste 100
Bend, OR 97703-3200
Phone (541) 389-4321

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100630000299 OR Part B Supplier - Clinic/Group Practice 9638200991 Receives reassigned benefits from 9 practitioners
Practice locations: Bend, OR

National Provider Directory

National Provider Directory

Locations

160 SW Scalehouse Loop
Ste 160
Bend, OR 97702
Phone (541) 312-4316

55 NW Wall St
Ste 100
Bend, OR 97703
Phone (541) 389-4321

Practitioners & affiliated clinicians

Practitioners 68

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.

View all 68

NPI Registry JSON

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

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623110400000",
    "number": "1154449890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 NW WALL ST STE 100",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977033200",
            "telephone_number": "541-389-4321",
            "fax_number": "541-389-4420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 NW WALL ST STE 100",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977033200",
            "telephone_number": "541-389-4321",
            "fax_number": "541-389-4420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FALLING WATERS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-27",
        "last_updated": "2021-06-08",
        "certification_date": "2021-06-08",
        "status": "A",
        "authorized_official_last_name": "MCCLINTOCK",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "541-389-4321",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Jun 8, 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.