Active NPI
Justin Coryell
- Chiropractor
- Pleasant Hill, OR
National Provider Identifier
1538708011
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 6121
- Practice address
- 85203 Jasper Park Rd
Pleasant Hill, OR 97455-9773 - Phone
- (541) 852-8806
- NPI assigned
- Dec 31, 2019
- Sex
- Male
- Sole proprietor
- No
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 | 34713 | CA | |
| Chiropractor | 111N00000X | 6121 | OR | Primary |
Addresses
Primary practice location
85203 Jasper Park Rd
Pleasant Hill, OR 97455-9773
Mailing address
85203 Jasper Park Rd
Pleasant Hill, OR 97455-9773
Phone (541) 852-8806
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 34713 | CA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1577750400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1611273600000",
"number": "1538708011",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "85203 JASPER PARK RD",
"city": "PLEASANT HILL",
"state": "OR",
"postal_code": "974559773",
"telephone_number": "541-852-8806"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "85203 JASPER PARK RD",
"city": "PLEASANT HILL",
"state": "OR",
"postal_code": "974559773",
"telephone_number": "541-852-8806"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CORYELL",
"first_name": "JUSTIN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-12-31",
"last_updated": "2021-01-22",
"certification_date": "2021-01-15",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "CA",
"license": "34713",
"primary": false
},
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "OR",
"license": "6121",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pleasant Hill, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.