Active NPI
Kathryn Rae Cantwell, D.C.
- Chiropractor
- Beaverton, OR
National Provider Identifier
1386625010
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 5569
- Practice address
- 12325 SW Horizon Blvd
Suite 223
Beaverton, OR 97007-9474 - Phone
- (847) 309-3350
- Fax
- (847) 309-3350
- NPI assigned
- Nov 9, 2005
- Last updated
- Jun 10, 2016
- Sex
- Female
- 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 | 5569 | OR | Primary |
Addresses
Primary practice location
12325 SW Horizon Blvd
Suite 223
Beaverton, OR 97007-9474
Mailing address
4155 NE Three Mile LN
Unit 135
McMinnville, OR 97128-9431
Phone (847) 309-3350
Other names 1
- Dr. Kathryn Rae Cantwell
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160815001565 | OR | Practitioner - Chiropractic | 3072580869 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5569 | OR | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Adio Chiropractic Clinic SC | Chiropractor | Past | Accepting new patients |
| Dprchiro LLC | Chiropractor | Past | Accepting new patients |
Organizations & group practices 3
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.
-
- Chiropractor
- Libertyville, IL
- NPI 1104030964
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1131494400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1465516800000",
"number": "1386625010",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4155 NE THREE MILE LN",
"address_2": "UNIT 135",
"city": "MCMINNVILLE",
"state": "OR",
"postal_code": "971289431",
"telephone_number": "847-309-3350",
"fax_number": "847-309-3350"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12325 SW HORIZON BLVD",
"address_2": "SUITE 223",
"city": "BEAVERTON",
"state": "OR",
"postal_code": "970079474",
"telephone_number": "847-309-3350",
"fax_number": "847-309-3350"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CANTWELL",
"first_name": "KATHRYN",
"middle_name": "RAE",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2005-11-09",
"last_updated": "2016-06-10",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "OR",
"license": "5569",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "KATHRYN",
"last_name": "CANTWELL",
"middle_name": "RAE",
"prefix": "DR.",
"credential": "D.C.",
"code": "2",
"type": "Professional Name"
}
]
}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 Jun 10, 2016; 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.