Individual provider Active NPI

Bradley K Rethwill, D.C.

  • Chiropractor
  • Eugene, OR
National Provider Identifier
1548242183
Registry record updated Mar 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1834 Issued in OR
Practice address
1400 Executive Pkwy Ste 220
Eugene, OR 97401-7109
Phone
(541) 345-1669
Fax
(541) 359-2238
NPI assigned
Nov 18, 2005
Last updated
Mar 26, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 26, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1834 OR Primary

Addresses

Primary practice location

1400 Executive Pkwy Ste 220
Eugene, OR 97401-7109

Mailing address

1400 Executive Pkwy Ste 220
Eugene, OR 97401-7109
Phone (541) 345-1669

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

Practice roles

OrganizationSpecialtyStatusNew patients
Marks Family Chiropractic LLC Chiropractor CurrentSince Nov 16, 2021 Accepting new patients

Locations

1400 Executive Pkwy
Ste 220
Eugene, OR 97401
Phone (541) 345-1669

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1132272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585180800000",
    "number": "1548242183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 EXECUTIVE PKWY STE 220",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974017109",
            "telephone_number": "541-345-1669",
            "fax_number": "541-359-2238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 EXECUTIVE PKWY STE 220",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974017109",
            "telephone_number": "541-345-1669",
            "fax_number": "541-359-2238"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RETHWILL",
        "first_name": "BRADLEY",
        "middle_name": "K",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-18",
        "last_updated": "2020-03-26",
        "certification_date": "2020-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OR",
            "license": "1834",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eugene, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.