Organization Active NPI

Stumptown Chiropractic, LLC

  • Chiropractor
  • Portland, OR
National Provider Identifier
1205312170
Registry record updated Oct 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5660 Issued in OR
Legal business name
STUMPTOWN CHIROPRACTIC, LLC
Practice address
7232 N Burlington Ave
Portland, OR 97203-4817
Phone
(503) 893-8336
Fax
(503) 662-7324
NPI assigned
Jul 13, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2020

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

Authorized official

Name
Dr. Melissa Bartoszewski, DCNPI 1174896724
Title
Chiropractor/Owner
Phone
(503) 893-8336

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 5660 OR Primary

Addresses

Primary practice location

7232 N Burlington Ave
Portland, OR 97203-4817

Mailing address

7232 N Burlington Ave
Portland, OR 97203-4817
Phone (503) 893-8336

Other identifiers 2

IdentifierTypeStateIssuer
1174896724OtherORNPI
1205312170OtherNPI TYPE 2

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20221227000893 OR Part B Supplier - Clinic/Group Practice 4789054263 Receives reassigned benefits from 1 practitioner
Practice locations: Portland, OR

National Provider Directory

National Provider Directory

Locations

7232 N Burlington Ave
Portland, OR 97203
Phone (503) 893-8336

Practitioners & affiliated clinicians

Practitioners 1

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": "1531440000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603411200000",
    "number": "1205312170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7232 N BURLINGTON AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972034817",
            "telephone_number": "503-893-8336",
            "fax_number": "503-662-7324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7232 N BURLINGTON AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972034817",
            "telephone_number": "503-893-8336",
            "fax_number": "503-662-7324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STUMPTOWN CHIROPRACTIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-13",
        "last_updated": "2020-10-23",
        "certification_date": "2020-10-23",
        "status": "A",
        "authorized_official_last_name": "BARTOSZEWSKI",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_title_or_position": "CHIROPRACTOR/OWNER",
        "authorized_official_telephone_number": "503-893-8336",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "OR",
            "license": "5660",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1174896724",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI TYPE 2",
            "identifier": "1205312170",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2020; 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.