Robert Russell Bennett, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

2769 Issued in OR

Practice address

21885 Highway 62
Shady Cove, OR 97539

Phone

(541) 878-3603

Fax

(541) 878-3603

NPI assigned

Jan 17, 2007

Last updated

Jan 26, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Specialty

Chiropractic

Education

Western States College of Chiropractic, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Shady Cove Chiropractic LLCGroup PAC ID 5597156638, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Shady Cove Chiropractic, LLC

  • Chiropractor
  • Shady Cove, OR
  • NPI 1154089423
  Medicare reassignment Care Compare group NPD
• Southern Oregon Chiropractic-Central Point, LLC

  • Chiropractor
  • Central Point, OR
  • NPI 1952892945
  Medicare reassignment NPD
• Southern Oregon Chiropractic, LLC

  dba Southern Oregon Acupuncture

  • Chiropractor
  • Medford, OR
  • NPI 1891829370
  Medicare reassignment NPD

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

{
    "created_epoch": "1168992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643155200000",
    "number": "1285786525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 550",
            "city": "EAGLE POINT",
            "state": "OR",
            "postal_code": "975240550",
            "telephone_number": "541-878-3603",
            "fax_number": "541-878-3603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21885 HIGHWAY 62",
            "city": "SHADY COVE",
            "state": "OR",
            "postal_code": "97539",
            "telephone_number": "541-878-3603",
            "fax_number": "541-878-3603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "ROBERT",
        "middle_name": "RUSSELL",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-17",
        "last_updated": "2022-01-26",
        "certification_date": "2022-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OR",
            "license": "2769",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Neil Dale Arnspiger
• Mary J. Baker, FNP
• Philip Broesamle
• Central Drug Store Inc (Shady Cove Pharmacy)
• Paige Chick
• Casey Dean Clingan, DMD
• Eleanor Crescenzi

• Chiropractor in Shady Cove, OR
• Providers in Shady Cove, OR by specialty
• Chiropractor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2022; 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.