Individual provider Active NPI

Stephen G. Ray, DC

  • Chiropractor
  • Beaverton, OR
National Provider Identifier
1376548644
Registry record updated Feb 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
27 1452 Issued in OR
Practice address
8118 SW Hall Blvd
Beaverton, OR 97008-6446
Phone
(503) 469-9824
Fax
(503) 469-9324
NPI assigned
Jun 14, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 28, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 27 1452 OR Primary

Addresses

Primary practice location

8118 SW Hall Blvd
Beaverton, OR 97008-6446

Mailing address

8118 SW Hall Blvd
Beaverton, OR 97008-6446
Phone (503) 469-9824

Other identifiers 1

IdentifierTypeStateIssuer
112961OtherORKAISER PERMANENTE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120801000494 OR Practitioner - Chiropractic 6901062298 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1995
Medicare assignment
May accept Medicare assignment
Group practices
Shephard Clinic of the Chiropractic ArtsGroup PAC ID 5890784045, 2 clinicians

Practice addresses (Care Compare)

2323 NW Flanders St
Portland, OR 97210-3764
Phone (503) 223-3826

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
27 1452ORMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Shephard Clinic of the Chiropractic Arts CurrentSince Mar 5, 2024 Accepting new patients

Locations

2323 NW Flanders St
Portland, OR 97210
Phone (503) 223-3826

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": "1118707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204156800000",
    "number": "1376548644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8118 SW HALL BLVD",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970086446",
            "telephone_number": "503-469-9824",
            "fax_number": "503-469-9324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8118 SW HALL BLVD",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970086446",
            "telephone_number": "503-469-9824",
            "fax_number": "503-469-9324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAY",
        "first_name": "STEPHEN",
        "middle_name": "G.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-14",
        "last_updated": "2008-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OR",
            "license": "27 1452",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KAISER PERMANENTE",
            "identifier": "112961",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaverton, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2008; 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.