Individual provider Active NPI

Shamim Matin, D.C

  • Sports Physician Chiropractor
  • Hillsboro, OR
National Provider Identifier
1194953224
Registry record updated Sep 25, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Physician ChiropractorTaxonomy code 111NS0005X
License
5627 Issued in OR
Practice address
1964 NE 49TH Way
Hillsboro, OR 97124-1302
Phone
(503) 858-7845
NPI assigned
Jun 26, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 25, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Physician Chiropractor 111NS0005X 5627 OR Primary

Addresses

Primary practice location

1964 NE 49TH Way
Hillsboro, OR 97124-1302

Mailing address

1964 NE 49TH Way
Hillsboro, OR 97124-1302
Phone (503) 858-7845

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
5627ORMDSports Physician Chiropractor

NPI Registry JSON

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

{
    "created_epoch": "1245974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1443139200000",
    "number": "1194953224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1964 NE 49TH WAY",
            "city": "HILLSBORO",
            "state": "OR",
            "postal_code": "971241302",
            "telephone_number": "503-858-7845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1964 NE 49TH WAY",
            "city": "HILLSBORO",
            "state": "OR",
            "postal_code": "971241302",
            "telephone_number": "503-858-7845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATIN",
        "first_name": "SHAMIM",
        "credential": "D.C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-06-26",
        "last_updated": "2015-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "OR",
            "license": "5627",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hillsboro, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2015; 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.