Active NPI
Chiropractic Physicians and Rehabilitation, PC
- Chiropractor
- Portland, OR
National Provider Identifier
1164947149
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 3420
- Legal business name
- CHIROPRACTIC PHYSICIANS AND REHABILITATION, PC
- Practice address
- 11657 NE Glisan St
Portland, OR 97220-2264 - Phone
- (503) 252-3560
- Fax
- (503) 252-3199
- NPI assigned
- Aug 10, 2017
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Samantha E Stuart, DC
- Title
- Owner
- Phone
- (503) 252-3560
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 3420 | OR | Primary |
Addresses
Primary practice location
11657 NE Glisan St
Portland, OR 97220-2264
Mailing address
11657 NE Glisan St
Portland, OR 97220-2264
Phone (503) 252-3560
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3420 | Other | OR | ACTIVE CHIROPRACTIC LICENSE |
National Provider Directory
National Provider Directory- Tax ID family
- Chiropractic Physicians and Rehabilitation PC
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Chiropractor
- Portland, OR
- NPI 1538684519
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Chiropractor
- Portland, OR
- NPI 1386715548
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1502323200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1658361600000",
"number": "1164947149",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11657 NE GLISAN ST",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972202264",
"telephone_number": "503-252-3560",
"fax_number": "503-252-3199"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11657 NE GLISAN ST",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972202264",
"telephone_number": "503-252-3560",
"fax_number": "503-252-3199"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CHIROPRACTIC PHYSICIANS AND REHABILITATION, PC",
"organizational_subpart": "NO",
"enumeration_date": "2017-08-10",
"last_updated": "2022-07-21",
"status": "A",
"authorized_official_last_name": "STUART",
"authorized_official_first_name": "SAMANTHA",
"authorized_official_middle_name": "E",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "503-252-3560",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "DC"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Chiropractor",
"state": "OR",
"license": "3420",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ACTIVE CHIROPRACTIC LICENSE",
"identifier": "3420",
"state": "OR"
}
],
"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 Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.