NPIMap

Organization Active NPI

Locke Chiropractic LLC

  • Sports Physician Chiropractor
  • Tualatin, OR
National Provider Identifier
1275874380
Registry record updated May 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Physician ChiropractorTaxonomy code 111NS0005X
License
5005 Issued in OR
Legal business name
LOCKE CHIROPRACTIC LLC
Practice address
19767 SW 72ND Ave
Suite 103
Tualatin, OR 97062-8354
Phone
(503) 620-6480
Fax
(503) 684-4598
NPI assigned
Mar 14, 2013
Last updated
May 21, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 21, 2015

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

Authorized official

Name
Dr. Nicholas S Locke, D.C.NPI 1922383215
Title
Owner/Chiropractor
Phone
(503) 351-9792

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
Sports Physician ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111NS0005X 5005 OR Primary

Addresses

Primary practice location

19767 SW 72ND Ave
Suite 103
Tualatin, OR 97062-8354

Mailing address

19767 SW 72ND Ave
Suite 103
Tualatin, OR 97062-8354
Phone (503) 620-6480

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150729006929 OR Part B Supplier - Clinic/Group Practice 6901110451 Receives reassigned benefits from 2 practitioners
Practice locations: Tualatin, OR

National Provider Directory

National Provider Directory

Locations

19767 SW 72nd Ave
Ste 103
Tualatin, OR 97062
Phone (503) 620-6480

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1363219200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1432166400000",
    "number": "1275874380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19767 SW 72ND AVE",
            "address_2": "SUITE 103",
            "city": "TUALATIN",
            "state": "OR",
            "postal_code": "970628354",
            "telephone_number": "503-620-6480",
            "fax_number": "503-684-4598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19767 SW 72ND AVE",
            "address_2": "SUITE 103",
            "city": "TUALATIN",
            "state": "OR",
            "postal_code": "970628354",
            "telephone_number": "503-620-6480",
            "fax_number": "503-684-4598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOCKE CHIROPRACTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-14",
        "last_updated": "2015-05-21",
        "status": "A",
        "authorized_official_last_name": "LOCKE",
        "authorized_official_first_name": "NICHOLAS",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER/CHIROPRACTOR",
        "authorized_official_telephone_number": "503-351-9792",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor, Sports Physician",
            "state": "OR",
            "license": "5005",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tualatin, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2015; 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.