Active NPI
The Chiropractor PC
- Chiropractor
- Bend, OR
National Provider Identifier
1205077484
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 273266
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 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 ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20090424000122 | OR | Part B Supplier - Clinic/Group Practice | 6305994690 |
Receives reassigned benefits from 1 practitioner Practice locations: Bend, OR |
National Provider Directory
National Provider DirectoryLocations
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.
-
- Chiropractor
- Hillsboro, OR
- NPI 1205251220
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.