Individual provider Active NPI

Joan M. O'Connor, D.C.

  • Chiropractor
  • Portland, OR
National Provider Identifier
1164616587
Registry record updated Apr 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3066 Issued in OR
Practice address
8835 SW Canyon LN Ste 120
Portland, OR 97225-3451
Phone
(971) 348-3710
Fax
(971) 348-3711
NPI assigned
Aug 29, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 006 0001154 VT
Chiropractor 111N00000X 3066 OR Primary

Addresses

Primary practice location

8835 SW Canyon LN Ste 120
Portland, OR 97225-3451

Mailing address

8835 SW Canyon LN Ste 120
Portland, OR 97225-3451
Phone (971) 348-3710

Other identifiers 6

IdentifierTypeStateIssuer
472685OtherTUFTS HEALTH PLAN
472685OtherTUFTS
8328214OtherVTCIGNA
00068702OtherVTBCBSVT
UVN3721MedicaidVT
054008921VT01OtherANTHEM

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150825004145 OR Practitioner - Chiropractic 4385689629 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Western States College of Chiropractic, 1997
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

8835 SW Canyon LN
Suite 120
Portland, OR 97225-3451
Phone (971) 348-3710

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
006 0001154VTMDChiropractor
3000MAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
J2.0, LLC Chiropractor CurrentSince Jul 7, 2015 Accepting new patients
CDL Chiropractic Clinic, PC Chiropractor PastSince May 23, 2002 Accepting new patients
William a Econe DC PC Chiropractor Past Accepting new patients
William a. Econe D.C.,P.C. Past Accepting new patients

Locations

8835 SW Canyon Ln
Ste 120
Portland, OR 97225
Phone (971) 348-3710

1410 SW Marlow Ave
Ste A
Portland, OR 97225
Phone (503) 639-6454

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1188345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618099200000",
    "number": "1164616587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8835 SW CANYON LN STE 120",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972253451",
            "telephone_number": "971-348-3710",
            "fax_number": "971-348-3711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8835 SW CANYON LN STE 120",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972253451",
            "telephone_number": "971-348-3710",
            "fax_number": "971-348-3711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'CONNOR",
        "first_name": "JOAN",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-29",
        "last_updated": "2021-04-11",
        "certification_date": "2021-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "VT",
            "license": "006 0001154",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OR",
            "license": "3066",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS HEALTH PLAN",
            "identifier": "472685",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS",
            "identifier": "472685",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "8328214",
            "state": "VT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSVT",
            "identifier": "00068702",
            "state": "VT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "UVN3721",
            "state": "VT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "054008921VT01",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Apr 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.