Individual provider Active NPI

Samantha E Stuart, D.C.

  • Chiropractor
  • Portland, OR
National Provider Identifier
1386715548
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
273420 Issued in OR
Practice address
11657 NE Glisan St
Portland, OR 97220-2264
Phone
(503) 252-3560
Fax
(503) 252-3199
NPI assigned
Nov 10, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 273420 OR Primary

Addresses

Primary practice location

11657 NE Glisan St
Portland, OR 97220-2264

Mailing address

4845 SE Vintage PL
Milwaukie, OR 97267-5961
Phone (503) 320-8542

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
273420ORMDChiropractor
3420ORMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Chiropractic Physicians and Rehabilitation PC Chiropractor Current Accepting new patients
Chiropractic Physicians and Rehabilitation, PC Chiropractor Current Accepting new patients
Sherwood Family Chiropractic Clinic Chiropractor Past Accepting new patients

Locations

11657 NE Glisan St
Portland, OR 97220
Phone (503) 252-3560

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 and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1163116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1386715548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4845 SE VINTAGE PL",
            "city": "MILWAUKIE",
            "state": "OR",
            "postal_code": "972675961",
            "telephone_number": "503-320-8542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11657 NE GLISAN ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972202264",
            "telephone_number": "503-252-3560",
            "fax_number": "503-252-3199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STUART",
        "first_name": "SAMANTHA",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OR",
            "license": "273420",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.