Active NPI
Deirdre Leigh Dantonio, D.C.
- Chiropractor
- Medford, OR
National Provider Identifier
1508053158
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 282576
- Practice address
- 10 Crater Lake Ave
Medford, OR 97504-7445 - Phone
- (541) 608-0169
- NPI assigned
- Sep 27, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 282576 | OR | Primary |
| Chiropractor | 111N00000X | 782 | MT |
Addresses
Primary practice location
10 Crater Lake Ave
Medford, OR 97504-7445
Mailing address
5003 Griffin Creek Rd
Medford, OR 97501-9586
Phone (541) 608-0488
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Palmer College Chiropractic - Davenport, 1982
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
408 Crater Lake Ave
Medford, OR 97504-6808
Phone (541) 608-0169
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 782 | MT | MD | Chiropractor |
| 282576 | OR | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| D'Antonio Chiropractic Clinic LLC | Chiropractor | Current | Accepting new patients |
Locations
408 Crater Lake Ave
Medford, OR 97504
Phone (214) 697-5701
10 Crater Lake Ave
Medford, OR 97504
Phone (541) 608-0169
Organizations & group practices 1
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.
-
- Chiropractor
- Medford, OR
- NPI 1790294783
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1190851200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1190851200000",
"number": "1508053158",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5003 GRIFFIN CREEK RD",
"city": "MEDFORD",
"state": "OR",
"postal_code": "975019586",
"telephone_number": "541-608-0488"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10 CRATER LAKE AVE",
"city": "MEDFORD",
"state": "OR",
"postal_code": "975047445",
"telephone_number": "541-608-0169"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DANTONIO",
"first_name": "DEIRDRE",
"middle_name": "LEIGH",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-09-27",
"last_updated": "2007-09-27",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "OR",
"license": "282576",
"primary": true
},
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "MT",
"license": "782",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Medford, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2007; 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.