Individual provider Active NPI

Terrance E Erdman, D.C.

  • Chiropractor
  • Tigard, OR
National Provider Identifier
1295939247
Registry record updated Mar 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1268 Issued in OR
Practice address
12405 SW Main Street
Tigard, OR 97223-6109
Phone
(503) 620-4880
Fax
(503) 620-4886
NPI assigned
Jun 13, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1268 OR Primary

Addresses

Primary practice location

12405 SW Main Street
Tigard, OR 97223-6109

Mailing address

12405 SW Main Street
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
I20090227000505 OR Practitioner - Chiropractic 2365508249 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Western States College of Chiropractic, 1976
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1268ORMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Terrance E. Erdman D.C, P.C. Chiropractor CurrentSince Dec 5, 2008 Accepting new patients

Locations

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

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": "1181692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488931200000",
    "number": "1295939247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12405 SW MAIN STREET",
            "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 STREET",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972236109",
            "telephone_number": "503-620-4880",
            "fax_number": "503-620-4886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERDMAN",
        "first_name": "TERRANCE",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-13",
        "last_updated": "2017-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_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 Mar 8, 2017; 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.