Organization Active NPI

McMinnville Chiropractic Clinic LLC

  • Chiropractor
  • McMinnville, OR
National Provider Identifier
1396244661
Registry record updated Feb 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5879 Issued in OR
Legal business name
MCMINNVILLE CHIROPRACTIC CLINIC LLC
Practice address
351 SE Baker St
McMinnville, OR 97128-6039
Phone
(503) 434-9002
NPI assigned
Feb 1, 2018
Last updated
Feb 1, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2018

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

Authorized official

Name
Dr. Steven Britton Vierboom, DCNPI 1245748870
Title
Owner
Phone
(971) 260-7263

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
Chiropractor 111N00000X 5879 OR Primary

Addresses

Primary practice location

351 SE Baker St
McMinnville, OR 97128-6039

Mailing address

351 SE Baker St
McMinnville, OR 97128-6039
Phone (503) 434-9002

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180406001703 OR Part B Supplier - Clinic/Group Practice 9739442690 Receives reassigned benefits from 1 practitioner
Practice locations: McMinnville, OR

National Provider Directory

National Provider Directory

Locations

351 SE Baker St
McMinnville, OR 97128
Phone (503) 434-9002

609 NE Baker St
Ste 250
McMinnville, OR 97128
Phone (503) 434-9002

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1517443200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1517443200000",
    "number": "1396244661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "351 SE BAKER ST",
            "city": "MCMINNVILLE",
            "state": "OR",
            "postal_code": "971286039",
            "telephone_number": "503-434-9002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "351 SE BAKER ST",
            "city": "MCMINNVILLE",
            "state": "OR",
            "postal_code": "971286039",
            "telephone_number": "503-434-9002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCMINNVILLE CHIROPRACTIC CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-01",
        "last_updated": "2018-02-01",
        "status": "A",
        "authorized_official_last_name": "VIERBOOM",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "BRITTON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "971-260-7263",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OR",
            "license": "5879",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McMinnville, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2018; 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.