Active NPI
Kelly Chapman, D.C.
- Chiropractor
- Dallas, OR
National Provider Identifier
1376611434
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 27 3406
- Practice address
- 608 SE Jefferson St
Dallas, OR 97338-2024 - Phone
- (503) 623-2225
- Fax
- (503) 623-2425
- NPI assigned
- Nov 30, 2006
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 27 3406 | OR | Primary |
Addresses
Primary practice location
608 SE Jefferson St
Dallas, OR 97338-2024
Mailing address
608 SE Jefferson St
Dallas, OR 97338-2024
Phone (503) 623-2225
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 231091 | Medicaid | OR |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120111000942 | OR | Practitioner - Chiropractic | 9335316595 | Practice locations: Dallas, OR |
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Other, 2002
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
608 SE Jefferson St
Dallas, OR 97338-2024
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 27 3406 | OR | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164844800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1376611434",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "608 SE JEFFERSON ST",
"city": "DALLAS",
"state": "OR",
"postal_code": "973382024",
"telephone_number": "503-623-2225",
"fax_number": "503-623-2425"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "608 SE JEFFERSON ST",
"city": "DALLAS",
"state": "OR",
"postal_code": "973382024",
"telephone_number": "503-623-2225",
"fax_number": "503-623-2425"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHAPMAN",
"first_name": "KELLY",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-11-30",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "OR",
"license": "27 3406",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "231091",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Dallas, OR
- Jenna Lee Carrell, OMHA I
- Noelle K Carroll, PSY.D.
- Antonia Rose Cassell
- Center for Acceptance and Wellness P.C
- Robert Roddy Chandler, L.M.F.T
- Charles E Holton, Jr DC Inc
- Tammy Marie Chatfield, MA MFT
- Chiropractic First Wellness Center, LLC (Chiropractic First Wellness Center)
- Christopher D. Johnson OD, PC (Mid-Valley Eyecare)
- Peggy Ann Chupp
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.