Dale Jersome Ellwein, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

21958 Issued in CA

Practice address

1462 NE Cushing Dr Ste 180
Bend, OR 97701-9103

Phone

(541) 241-5072

NPI assigned

May 22, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Specialty

Chiropractic

Education

Life Chiropractic College - West, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Standing Tall Chiropractic, Inc.

  • Chiropractor
  • Bend, OR
  • NPI 1962097212
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646697600000",
    "number": "1386854263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1462 NE CUSHING DR STE 250",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977019102",
            "telephone_number": "541-241-5072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1462 NE CUSHING DR STE 180",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977019103",
            "telephone_number": "541-241-5072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLWEIN",
        "first_name": "DALE",
        "middle_name": "JERSOME",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-22",
        "last_updated": "2022-03-08",
        "certification_date": "2022-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "21958",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathleen Elliott, M.A., M.F.T.
• Melinda Leigh Elliott
• Noelle Elliott
• Olivia Ellis, PT, DPT
• Sally Ellsworth
• Laura Elmore, LMT
• Kaylin Elizabeth Elms
• Katelyn E Elston
• Rachel Evon Elzinga, RD
• Cara Emard

• Chiropractor in Bend, OR
• Providers in Bend, OR by specialty
• Chiropractor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2022; 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.