Individual provider Active NPI

Tyge Brandon Shelby, D.C.

  • Chiropractor
  • Bend, OR
National Provider Identifier
1407939234
Registry record updated Dec 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3460 Issued in OR
Practice address
409 NE Greenwood Ave Ste 120
Bend, OR 97701-4616
Phone
(541) 728-0954
Fax
(541) 728-0956
NPI assigned
Oct 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3460 OR Primary

Addresses

Primary practice location

409 NE Greenwood Ave Ste 120
Bend, OR 97701-4616

Mailing address

409 NE Greenwood Ave Ste 120
Bend, OR 97701-4616
Phone (541) 728-0954

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050211000786 OR Practitioner - Chiropractic 8123070695 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College - West, 2001
Medicare assignment
May accept Medicare assignment
Group practices
2Chirosmission Chiropractic Center LLCGroup PAC ID 2769624824, 6 clinicians

Practice addresses (Care Compare)

409 NE Greenwood Ave
Suite 120
Bend, OR 97701-4616
Phone (541) 728-0954

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Practice roles

OrganizationSpecialtyStatusNew patients
2Chirosmission Chiropractic Center LLC Chiropractor CurrentSince Jun 29, 2022 Accepting new patients
Shelby Chiropractic Chiropractor Past Accepting new patients
Summit Chiropractic Inc Chiropractor PastSince Sep 5, 2018 Accepting new patients

Locations

409 NE Greenwood Ave
Ste 120
Bend, OR 97701
Phone (541) 728-0954

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": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640131200000",
    "number": "1407939234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409 NE GREENWOOD AVE STE 120",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977014616",
            "telephone_number": "541-728-0954",
            "fax_number": "541-728-0956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "409 NE GREENWOOD AVE STE 120",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977014616",
            "telephone_number": "541-728-0954",
            "fax_number": "541-728-0956"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHELBY",
        "first_name": "TYGE",
        "middle_name": "BRANDON",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-23",
        "last_updated": "2021-12-22",
        "certification_date": "2021-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OR",
            "license": "3460",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bend, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2021; 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.