Organization Active NPI

Cascade Chiropractic of Southern Oregon, LLC

  • Chiropractor
  • Grants Pass, OR
National Provider Identifier
1396137295
Registry record updated Dec 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
CASCADE CHIROPRACTIC OF SOUTHERN OREGON, LLC
Practice address
745 NE 7TH St
Grants Pass, OR 97526-1632
Phone
(541) 472-0500
Fax
(541) 471-6285
NPI assigned
Mar 2, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2015

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

Authorized official

Name
Kelsey Reeser, DCNPI 1760412670
Title
Owner
Phone
(541) 472-0500

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

745 NE 7TH St
Grants Pass, OR 97526-1632

Mailing address

745 NE 7TH St
Grants Pass, OR 97526-1632
Phone (541) 472-0500

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160113001433 OR Part B Supplier - Clinic/Group Practice 2466754098 Receives reassigned benefits from 2 practitioners
Practice locations: Grants Pass, OR

National Provider Directory

National Provider Directory

Locations

745 NE 7th St
Grants Pass, OR 97526
Phone (541) 472-0500

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1425254400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1451260800000",
    "number": "1396137295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "745 NE 7TH ST",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975261632",
            "telephone_number": "541-472-0500",
            "fax_number": "541-471-6285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "745 NE 7TH ST",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975261632",
            "telephone_number": "541-472-0500",
            "fax_number": "541-471-6285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CASCADE CHIROPRACTIC OF SOUTHERN OREGON, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-02",
        "last_updated": "2015-12-28",
        "status": "A",
        "authorized_official_last_name": "REESER",
        "authorized_official_first_name": "KELSEY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "541-472-0500",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grants Pass, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2015; 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.

Verify at the official NPI Registry.