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
Organization subpart
No

Authorized official

NPPES NPI Registry
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.

Practitioners 67

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 67

Medicare participation

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

Medicare enrollment records 1

Medicare enrollment files
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

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

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X Primary

Addresses

NPPES NPI Registry

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

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 8, 2021.

{
    "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.