NPIMap

Organization Active NPI

Wellspring Chiropractic, PC

  • Chiropractor
  • Saint Helens, OR
National Provider Identifier
1174839989
Registry record updated Aug 31, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2864 Issued in OR
Legal business name
WELLSPRING CHIROPRACTIC, PC
Practice address
165 N 11TH St
Saint Helens, OR 97051-1803
Phone
(503) 397-2202
Fax
(503) 397-7113
NPI assigned
Aug 31, 2010
Last updated
Aug 31, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2010

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

Authorized official

Name
Dr. Kevin Lee McCausland, D.C.
Title
President
Phone
(503) 397-2202

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 2864 OR Primary

Addresses

Primary practice location

165 N 11TH St
Saint Helens, OR 97051-1803

Mailing address

165 N 11TH St
Saint Helens, OR 97051-1803
Phone (503) 397-2202

Other identifiers 1

IdentifierTypeStateIssuer
R102662OtherORMEDICARE (UNSURE IWHAT OPTION ABOVE APPLIES)

National Provider Directory

National Provider Directory

Locations

165 N 11th St
Saint Helens, OR 97051
Phone (503) 397-2202

NPI Registry JSON

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

{
    "created_epoch": "1283212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1283212800000",
    "number": "1174839989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "165 N 11TH ST",
            "city": "SAINT HELENS",
            "state": "OR",
            "postal_code": "970511803",
            "telephone_number": "503-397-2202",
            "fax_number": "503-397-7113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 N 11TH ST",
            "city": "SAINT HELENS",
            "state": "OR",
            "postal_code": "970511803",
            "telephone_number": "503-397-2202",
            "fax_number": "503-397-7113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLSPRING CHIROPRACTIC, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-31",
        "last_updated": "2010-08-31",
        "status": "A",
        "authorized_official_last_name": "MCCAUSLAND",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "503-397-2202",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "OR",
            "license": "2864",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE  (UNSURE IWHAT OPTION ABOVE APPLIES)",
            "identifier": "R102662",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Helens, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2010; 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.