Individual provider Active NPI

Amelia Schildmeyer

  • Chiropractor
  • Portland, OR
National Provider Identifier
1467901348
Registry record updated Oct 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5757 Issued in OR
Practice address
3241 NE Broadway St
Portland, OR 97232-1814
Phone
(503) 282-8582
Fax
(503) 460-0814
NPI assigned
Oct 3, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 3, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 5757 OR Primary

Addresses

Primary practice location

3241 NE Broadway St
Portland, OR 97232-1814

Mailing address

3241 NE Broadway St
Portland, OR 97232-1814
Phone (503) 282-8582

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161027001733 OR Practitioner - Chiropractic 1658659552 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Western States College of Chiropractic, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Somatic IncGroup PAC ID 5799110490, 3 clinicians

Practice addresses (Care Compare)

3543 NE Broadway St
Portland, OR 97232-1820
Phone (971) 351-2270

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5757ORMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Somatic Inc Chiropractor CurrentSince Oct 14, 2019 Accepting new patients
Center for Chiropractic & Pain Rehabilitation, LLC CurrentSince Oct 9, 2016 Accepting new patients

Locations

3241 NE Broadway St
Portland, OR 97232
Phone (503) 267-9080

3543 NE Broadway St
Portland, OR 97232
Phone (971) 351-2270

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1475452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475452800000",
    "number": "1467901348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3241 NE BROADWAY ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972321814",
            "telephone_number": "503-282-8582",
            "fax_number": "503-460-0814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3241 NE BROADWAY ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972321814",
            "telephone_number": "503-282-8582",
            "fax_number": "503-460-0814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHILDMEYER",
        "first_name": "AMELIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-10-03",
        "last_updated": "2016-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OR",
            "license": "5757",
            "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 Oct 3, 2016; 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.