Individual provider Active NPI

Grant T Dawson, D.C.

  • Chiropractor
  • Tualatin, OR
National Provider Identifier
1417991100
Registry record updated Jan 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
27-1240 Issued in OR
Practice address
19767 SW 72ND Ave
Suite 103
Tualatin, OR 97062-8354
Phone
(503) 620-6480
Fax
(503) 684-4598
NPI assigned
Jun 15, 2006
Last updated
Jan 30, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 27-1240 OR Primary

Addresses

Primary practice location

19767 SW 72ND Ave
Suite 103
Tualatin, OR 97062-8354

Mailing address

19767 SW 72ND Ave
Suite 103
Tualatin, OR 97062-8354
Phone (503) 620-6480

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
27-1240ORMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Locke Chiropractic LLC CurrentSince May 9, 2015 Accepting new patients

Locations

19767 SW 72nd Ave
Ste 103
Tualatin, OR 97062
Phone (503) 620-6480

Interoperability endpoints

  • Direct secure messaging: gtd@dc0016.direct.chirotouch.md

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327881600000",
    "number": "1417991100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19767 SW 72ND AVE",
            "address_2": "SUITE 103",
            "city": "TUALATIN",
            "state": "OR",
            "postal_code": "970628354",
            "telephone_number": "503-620-6480",
            "fax_number": "503-684-4598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19767 SW 72ND AVE",
            "address_2": "SUITE 103",
            "city": "TUALATIN",
            "state": "OR",
            "postal_code": "970628354",
            "telephone_number": "503-620-6480",
            "fax_number": "503-684-4598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAWSON",
        "first_name": "GRANT",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-15",
        "last_updated": "2012-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OR",
            "license": "27-1240",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tualatin, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2012; 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.