Organization Active NPI

The Chiropractor PC

  • Chiropractor
  • Bend, OR
National Provider Identifier
1205077484
Registry record updated Sep 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
273266 Issued in OR
Legal business name
THE CHIROPRACTOR PC
Practice address
61535 S Highway 97 Ste 18
Bend, OR 97702
Phone
(541) 383-4255
NPI assigned
Mar 17, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2023

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

Authorized official

Name
Mrs. Tania Rueben
Title
Office Manager
Phone
(415) 647-2055

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 273266 OR Primary

Addresses

Primary practice location

61535 S Highway 97 Ste 18
Bend, OR 97702

Mailing address

61535 S Highway 97 Ste 18
Bend, OR 97702-2156
Phone (541) 383-4255

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090424000122 OR Part B Supplier - Clinic/Group Practice 6305994690 Receives reassigned benefits from 1 practitioner
Practice locations: Bend, OR

National Provider Directory

National Provider Directory

Locations

61535 S Highway 97
Bend, OR 97702
Phone (541) 385-6658

61535 S Highway 97
Ste 18
Bend, OR 97702
Phone (541) 383-4255

1400 NE 48th Ave
Ste 400
Hillsboro, OR 97124
Phone (503) 547-8400

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1237248000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695859200000",
    "number": "1205077484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "61535 S HIGHWAY 97 STE 18",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977022156",
            "telephone_number": "541-383-4255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "61535 S HIGHWAY 97 STE 18",
            "city": "BEND",
            "state": "OR",
            "postal_code": "97702",
            "telephone_number": "541-383-4255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE CHIROPRACTOR PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-17",
        "last_updated": "2023-09-28",
        "certification_date": "2023-09-28",
        "status": "A",
        "authorized_official_last_name": "RUEBEN",
        "authorized_official_first_name": "TANIA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "415-647-2055",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "OR",
            "license": "273266",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bend, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.