Individual provider Active NPI

Lindsay Nicholson

  • Chiropractor
  • Clackamas, OR
National Provider Identifier
1245865153
Registry record updated Mar 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
6069 Issued in OR
Practice address
8810 SE Sunnybrook Blvd Ste 100
Clackamas, OR 97015-6805
Phone
(503) 607-2226
NPI assigned
Mar 11, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 6069 OR Primary

Addresses

Primary practice location

8810 SE Sunnybrook Blvd Ste 100
Clackamas, OR 97015-6805

Mailing address

1450 N Prescott St Apt 406
Portland, OR 97217-3207
Phone (971) 517-5086

Other practice location 1

10915 SE Stark St
Portland, OR 97216-3348
Phone (503) 261-1120

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL clackamas

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)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Pivot Health Acupuncture CurrentSince Jan 28, 2024 Accepting new patients

Locations

8810 SE Sunnybrook Blvd
Ste 100
Clackamas, OR 97015
Phone (503) 261-1120

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": "1583884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583884800000",
    "number": "1245865153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1450 N PRESCOTT ST APT 406",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972173207",
            "telephone_number": "971-517-5086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8810 SE SUNNYBROOK BLVD STE 100",
            "city": "CLACKAMAS",
            "state": "OR",
            "postal_code": "970156805",
            "telephone_number": "503-607-2226"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10915 SE Stark St",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972163348",
            "country_code": "US",
            "telephone_number": "503-261-1120",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NICHOLSON",
        "first_name": "LINDSAY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-11",
        "last_updated": "2020-03-11",
        "certification_date": "2020-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OR",
            "license": "6069",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "clackamas",
            "affiliation": "N",
            "address_1": "8810 SE Sunnybrook Blvd Ste 100",
            "city": "Clackamas",
            "state": "OR",
            "country_code": "US",
            "postal_code": "970156805",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Clackamas, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2020; 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.