Individual provider Active NPI

Carrie Nicole Ebling, DC

  • Chiropractor
  • Portland, OR
National Provider Identifier
1215178496
Registry record updated Nov 14, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3917 Issued in OR
Practice address
2915 SE Belmont St Ste 1
Portland, OR 97214-4084
Phone
(503) 505-9677
Fax
(503) 427-9765
NPI assigned
Mar 17, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 14, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3917 OR Primary

Addresses

Primary practice location

2915 SE Belmont St Ste 1
Portland, OR 97214-4084

Mailing address

2915 SE Belmont St Ste 1
Portland, OR 97214-4084
Phone (503) 505-9677

Other practice location 1

127 NE 130th Pl
Portland, OR 97230-2501
Phone (403) 449-7797

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
3917ORMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Elemental Medicine PastSince Dec 15, 2019 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and 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-1",
    "last_updated_epoch": "1510617600000",
    "number": "1215178496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2915 SE BELMONT ST STE 1",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972144084",
            "telephone_number": "503-505-9677",
            "fax_number": "503-427-9765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2915 SE BELMONT ST STE 1",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972144084",
            "telephone_number": "503-505-9677",
            "fax_number": "503-427-9765"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "127 NE 130th Pl",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972302501",
            "country_code": "US",
            "telephone_number": "403-449-7797",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EBLING",
        "first_name": "CARRIE",
        "middle_name": "NICOLE",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-03-17",
        "last_updated": "2017-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OR",
            "license": "3917",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Nov 14, 2017; 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.