Individual provider Active NPI

Jessi Gradin, D.C

  • Chiropractor
  • McMinnville, OR
National Provider Identifier
1538633094
Registry record updated May 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5968 Issued in OR
Practice address
850 SW Booth Bend Rd
McMinnville, OR 97128
Phone
(503) 472-2111
Fax
(503) 434-5886
NPI assigned
Jan 17, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 5968 OR Primary

Addresses

Primary practice location

850 SW Booth Bend Rd
McMinnville, OR 97128

Mailing address

850 SW Booth Bend Rd
McMinnville, OR 97128
Phone (503) 472-2111

Other names 1

  • Jessi Cox Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190213001584 OR Practitioner - Chiropractic 1557609724 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northwest Spine and Sport LLCGroup PAC ID 4880817105, 3 clinicians

Practice addresses (Care Compare)

850 SW Booth Bend Rd
McMinnville, OR 97128-9320
Phone (503) 472-2111

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5968ORMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Spine and Sport LLC CurrentSince May 1, 2024 Accepting new patients
Hosmer Chiropractic Health LLC CurrentSince Jan 17, 2019 Accepting new patients

Locations

850 SW Booth Bend Rd
McMinnville, OR 97128
Phone (503) 472-2111

1030 NW Marshall St
Portland, OR 97209
Phone (503) 227-2279

7689 SW Capitol Hwy
Portland, OR 97219
Phone (503) 445-4454

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": "1547683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716249600000",
    "number": "1538633094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 SW BOOTH BEND RD",
            "city": "MCMINNVILLE",
            "state": "OR",
            "postal_code": "97128",
            "telephone_number": "503-472-2111",
            "fax_number": "503-434-5886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 SW BOOTH BEND RD",
            "city": "MCMINNVILLE",
            "state": "OR",
            "postal_code": "97128",
            "telephone_number": "503-472-2111",
            "fax_number": "503-434-5886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRADIN",
        "first_name": "JESSI",
        "name_prefix": "Dr.",
        "credential": "D.C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-17",
        "last_updated": "2024-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OR",
            "license": "5968",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSI",
            "last_name": "COX",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in McMinnville, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2024; 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.