NPIMap

Organization Active NPI

Concordia Chiropractic Center LLC

  • Chiropractor
  • Portland, OR
National Provider Identifier
1437216314
Registry record updated Apr 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
273250 Issued in OR
Legal business name
CONCORDIA CHIROPRACTIC CENTER LLC
Practice address
5425 NE 33Rd Ave
Portland, OR 97211-7403
Phone
(503) 287-2273
Fax
(503) 287-2270
NPI assigned
Jan 2, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2010

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

Authorized official

Name
Dr. Jason Lee Lindekugel, D.C.NPI 1396810800
Title
Chiropractor
Phone
(503) 287-2273

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 273250 OR Primary

Addresses

Primary practice location

5425 NE 33Rd Ave
Portland, OR 97211-7403

Mailing address

5425 NE 33Rd Ave
Portland, OR 97211-7403
Phone (503) 287-2273

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100414000755 OR Part B Supplier - Clinic/Group Practice 1759418262 Receives reassigned benefits from 1 practitioner
Practice locations: Portland, OR

National Provider Directory

National Provider Directory

Locations

5425 NE 33rd Ave
Portland, OR 97211
Phone (503) 287-2273

Practitioners & affiliated clinicians

Practitioners 5

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": "1167696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1271289600000",
    "number": "1437216314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5425 NE 33RD AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972117403",
            "telephone_number": "503-287-2273",
            "fax_number": "503-287-2270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5425 NE 33RD AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972117403",
            "telephone_number": "503-287-2273",
            "fax_number": "503-287-2270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONCORDIA CHIROPRACTIC CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-02",
        "last_updated": "2010-04-15",
        "status": "A",
        "authorized_official_last_name": "LINDEKUGEL",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "503-287-2273",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "OR",
            "license": "273250",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2010; 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.