Organization Active NPI

Chiropractic Advantage Inc

  • Chiropractor
  • Keizer, OR
National Provider Identifier
1225882012
Registry record updated Oct 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
CHIROPRACTIC ADVANTAGE INC
Practice address
3990 Cherry Ave NE Ste 102
Keizer, OR 97303-4888
Phone
(971) 332-5919
NPI assigned
Apr 16, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2024

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

Authorized official

Name
Jason HoltNPI 1033651906
Title
Provider
Phone
(971) 332-5919

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X Primary
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X

Addresses

Primary practice location

3990 Cherry Ave NE Ste 102
Keizer, OR 97303-4888

Mailing address

3990 Cherry Ave NE Ste 102
Keizer, OR 97303-4888

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241104000588 OR Part B Supplier - Clinic/Group Practice 9830622539 Receives reassigned benefits from 2 practitioners
Practice locations: Keizer, OR

National Provider Directory

National Provider Directory

Locations

3990 Cherry Ave NE
Ste 102
Keizer, OR 97303
Phone (971) 332-5919

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": "1713225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728259200000",
    "number": "1225882012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3990 CHERRY AVE NE STE 102",
            "city": "KEIZER",
            "state": "OR",
            "postal_code": "973034888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3990 CHERRY AVE NE STE 102",
            "city": "KEIZER",
            "state": "OR",
            "postal_code": "973034888",
            "telephone_number": "971-332-5919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHIROPRACTIC ADVANTAGE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-16",
        "last_updated": "2024-10-07",
        "certification_date": "2024-10-07",
        "status": "A",
        "authorized_official_last_name": "HOLT",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "PROVIDER",
        "authorized_official_telephone_number": "971-332-5919"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Keizer, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2024; 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.