Individual provider Active NPI

Vernon Troy Hubbell, B.S., D.C.

  • Nutrition Chiropractor
  • Salem, OR
National Provider Identifier
1255790184
Registry record updated Feb 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nutrition ChiropractorTaxonomy code 111NN1001X
License
5712 Issued in OR
Practice address
830 Saginaw St S
Salem, OR 97302-4122
Phone
(503) 480-0200
NPI assigned
Feb 20, 2016
Last updated
Feb 20, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 20, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nutrition Chiropractor 111NN1001X 5712 OR Primary

Addresses

Primary practice location

830 Saginaw St S
Salem, OR 97302-4122

Mailing address

830 Saginaw St S
Salem, OR 97302-4122
Phone (503) 480-0200

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160926000491 OR Practitioner - Chiropractic 3577850130 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College - West, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

830 Saginaw St S
Salem, OR 97302-4122
Phone (503) 480-0200

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5712ORMDNutrition Chiropractor

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1455926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455926400000",
    "number": "1255790184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "830 SAGINAW ST S",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973024122",
            "telephone_number": "503-480-0200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 SAGINAW ST S",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973024122",
            "telephone_number": "503-480-0200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUBBELL",
        "first_name": "VERNON",
        "middle_name": "TROY",
        "name_prefix": "Dr.",
        "credential": "B.S., D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-02-20",
        "last_updated": "2016-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NN1001X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Nutrition",
            "state": "OR",
            "license": "5712",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2016; 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.