Individual provider Active NPI

Colin Ray Bettleyon, DC

  • Chiropractor
  • Portland, ME
National Provider Identifier
1194596817
Registry record updated Jul 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CR2974 Issued in ME
Practice address
949 Brighton Ave Ste 1
Portland, ME 04102-1060
Phone
(207) 780-1070
NPI assigned
Jan 11, 2024
Last updated
Jul 17, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 17, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CR2974 ME Primary
Sports Physician Chiropractor 111NS0005X CR2974 ME

Addresses

Primary practice location

949 Brighton Ave Ste 1
Portland, ME 04102-1060

Mailing address

949 Brighton Ave Ste 1
Portland, ME 04102-1060
Phone (207) 780-1070

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240725001757 ME Practitioner - Chiropractic 5890231914 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
New York Chiropractic College, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Healthworx LLCGroup PAC ID 8325405764, 4 clinicians

Practice addresses (Care Compare)

949 Brighton Ave
Portland, ME 04102-1060
Phone (207) 780-1070

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CR2974MEMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Healthworx, LLC Chiropractor CurrentSince May 18, 2024 Accepting new patients
Brown Chiropractic LLC Chiropractor PastSince Jan 1, 2024 Accepting new patients
Me Integrative Health Services LLC Chiropractor PastSince Jan 1, 2024 Accepting new patients

Locations

949 Brighton Ave
Portland, ME 04102
Phone (207) 780-1070

949 Brighton Ave
Ste 1
Portland, ME 04102
Phone (207) 548-5741

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1704931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721174400000",
    "number": "1194596817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "949 BRIGHTON AVE STE 1",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041021060",
            "telephone_number": "207-780-1070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "949 BRIGHTON AVE STE 1",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041021060",
            "telephone_number": "207-780-1070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BETTLEYON",
        "first_name": "COLIN",
        "middle_name": "RAY",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-01-11",
        "last_updated": "2024-07-17",
        "certification_date": "2024-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "ME",
            "license": "CR2974",
            "primary": true
        },
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "ME",
            "license": "CR2974",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2024; 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.