NPIMap

Organization Active NPI

Terrance E. Erdman D.C, P.C.

  • Chiropractor
  • Tigard, OR
National Provider Identifier
1255504544
Registry record updated Jun 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1268 Issued in OR
Legal business name
TERRANCE E. ERDMAN D.C, P.C.
Practice address
12405 SW Main St
Tigard, OR 97223-6109
Phone
(503) 620-4880
Fax
(503) 620-4886
NPI assigned
Apr 8, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2008

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

Authorized official

Name
Terrance Eugene Erdman, D.C., P.C.NPI 1295939247
Title
Owner
Phone
(503) 620-4880

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 1268 OR Primary

Addresses

Primary practice location

12405 SW Main St
Tigard, OR 97223-6109

Mailing address

12405 SW Main St
Tigard, OR 97223-6109
Phone (503) 620-4880

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090313000231 OR Part B Supplier - Clinic/Group Practice 6507922788 Receives reassigned benefits from 1 practitioner
Practice locations: Tigard, OR

National Provider Directory

National Provider Directory

Locations

12405 SW Main St
Tigard, OR 97223
Phone (503) 620-4880

Practitioners & affiliated clinicians

Practitioners 9

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": "1207612800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213574400000",
    "number": "1255504544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12405 SW MAIN ST",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972236109",
            "telephone_number": "503-620-4880",
            "fax_number": "503-620-4886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12405 SW MAIN ST",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972236109",
            "telephone_number": "503-620-4880",
            "fax_number": "503-620-4886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TERRANCE E. ERDMAN D.C, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-08",
        "last_updated": "2008-06-16",
        "status": "A",
        "authorized_official_last_name": "ERDMAN",
        "authorized_official_first_name": "TERRANCE",
        "authorized_official_middle_name": "EUGENE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-620-4880",
        "authorized_official_credential": "D.C., P.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "OR",
            "license": "1268",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tigard, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2008; 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.