Individual provider Active NPI

Jeffrey Bratten, DC, BS

  • Chiropractor
  • Gresham, OR
National Provider Identifier
1245399658
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
272765 Issued in OR
Practice address
1155 NE Hogan Dr
Gresham, OR 97030-4129
Phone
(503) 667-3366
Fax
(503) 465-8486
NPI assigned
Dec 8, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 272765 OR Primary

Addresses

Primary practice location

1155 NE Hogan Dr
Gresham, OR 97030-4129

Mailing address

1155 NE Hogan Dr
Gresham, OR 97030-4129
Phone (503) 667-3366

Other identifiers 1

IdentifierTypeStateIssuer
93-1083040OtherORTAX ID #

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111229000695 OR Practitioner - Chiropractic 7416123187 Practice locations: Gresham, OR

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Western States College of Chiropractic, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1155 NE Hogan Dr
Gresham, OR 97030-4129
Phone (503) 667-3366

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Bachelor of Science

State licenses

LicenseStateTypeSpecialty
2765ORMDClinical Psychologist
272765ORMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1165536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1245399658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1155 NE HOGAN DR",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970304129",
            "telephone_number": "503-667-3366",
            "fax_number": "503-465-8486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1155 NE HOGAN DR",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970304129",
            "telephone_number": "503-667-3366",
            "fax_number": "503-465-8486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRATTEN",
        "first_name": "JEFFREY",
        "name_prefix": "Dr.",
        "credential": "DC, BS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OR",
            "license": "272765",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID #",
            "identifier": "93-1083040",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gresham, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.