Individual provider Active NPI

Teri Lyn Gabriel, DC

  • Chiropractor
  • Gresham, OR
National Provider Identifier
1477594539
Registry record updated Jun 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3601 Issued in OR
Practice address
1748 NW Faiview Dr
Gresham, OR 97030-3842
Phone
(503) 492-3910
Fax
(503) 674-6706
NPI assigned
Jun 9, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3601 OR Primary
Chiropractor 111N00000X CH00034518 WA

Addresses

Primary practice location

1748 NW Faiview Dr
Gresham, OR 97030-3842

Mailing address

1748 NW Faiview Dr
Gresham, OR 97030-3842
Phone (503) 492-3910

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120404000281 OR Practitioner - Chiropractic 8123044898 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Western States College of Chiropractic, 2005
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1748 NW Fairview Dr
Gresham, OR 97030-3842
Phone (503) 492-3910

1748 NW Faiview Dr
Gresham, OR 97030-3842

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3601ORMDChiropractor
CH00034518WAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Nu-Life Sportsmedicine and Health Care Center PLLC Chiropractor Past Accepting new patients
Blume Family Chiropractic & Massage, Inc Chiropractor Past Accepting new patients
Family Chiropractic Inc Chiropractor Past Accepting new patients
Battle Ground Advantage Chiropractic PS Chiropractor PastSince Jul 31, 2023 Accepting new patients
Advantage Chiropratic & Massage, P.S. Chiropractor PastSince Aug 2, 2009 Accepting new patients

Organizations & group practices 6

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": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561334400000",
    "number": "1477594539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1748 NW FAIVIEW DR",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970303842",
            "telephone_number": "503-492-3910",
            "fax_number": "503-674-6706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1748 NW FAIVIEW DR",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970303842",
            "telephone_number": "503-492-3910",
            "fax_number": "503-674-6706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GABRIEL",
        "first_name": "TERI LYN",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-09",
        "last_updated": "2019-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OR",
            "license": "3601",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH00034518",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gresham, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2019; 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.