Organization Active NPI

Fisher Family Chiropractic & Blue Mountain Chiropractic

  • Chiropractor
  • Pendleton, OR
National Provider Identifier
1356871214
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3786 Issued in OR
Legal business name
FISHER FAMILY CHIROPRACTIC & BLUE MOUNTAIN CHIROPRACTIC
Practice address
424 SW 6TH St
Pendleton, OR 97801-2026
Phone
(541) 278-6880
Fax
(541) 797-6474
NPI assigned
Jun 14, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Dr. Conan Scott Fisher, DCNPI 1477738870
Title
Owner
Phone
(541) 278-6880

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 3786 OR Primary

Addresses

Primary practice location

424 SW 6TH St
Pendleton, OR 97801-2026

Mailing address

424 SW 6TH St
Pendleton, OR 97801-2026
Phone (541) 278-6880

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170803001706 OR Part B Supplier - Clinic/Group Practice 4385915701 Receives reassigned benefits from 2 practitioners
Practice locations: Pendleton, OR

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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": "1497398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1356871214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "424 SW 6TH ST",
            "city": "PENDLETON",
            "state": "OR",
            "postal_code": "978012026",
            "telephone_number": "541-278-6880",
            "fax_number": "541-797-6474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "424 SW 6TH ST",
            "city": "PENDLETON",
            "state": "OR",
            "postal_code": "978012026",
            "telephone_number": "541-278-6880",
            "fax_number": "541-797-6474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FISHER FAMILY CHIROPRACTIC & BLUE MOUNTAIN CHIROPRACTIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-14",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "FISHER",
        "authorized_official_first_name": "CONAN",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "541-278-6880",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "OR",
            "license": "3786",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pendleton, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.