Individual provider Active NPI

Nicole L Holton, DC

  • Chiropractor
  • Portland, OR
National Provider Identifier
1558692947
Registry record updated Jun 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3983 Issued in OR
Practice address
4531 SE Belmont St Ste 302
Portland, OR 97215-1699
Phone
(503) 236-9609
Fax
(503) 236-2906
NPI assigned
Jan 25, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 28, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3983 OR Primary

Addresses

Primary practice location

4531 SE Belmont St Ste 302
Portland, OR 97215-1699

Mailing address

4531 SE Belmont St Ste 302
Portland, OR 97215-1699
Phone (503) 236-9609

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100225000913 OR Practitioner - Chiropractic 7719021997 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
National College of Chiropractic, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4531 SE Belmont St
Suite 203
Portland, OR 97215-1675
Phone (503) 236-9609

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3983ORMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Nicole Holton, DC, PC Chiropractor CurrentSince Feb 25, 2010 Accepting new patients

Locations

4531 SE Belmont St
Ste 203
Portland, OR 97215
Phone (503) 236-9609

516 SE Morrison St
Ste 1110
Portland, OR 97214
Phone (503) 222-0707

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.

NPI Registry JSON

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

{
    "created_epoch": "1264377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656374400000",
    "number": "1558692947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4531 SE BELMONT ST STE 302",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972151699",
            "telephone_number": "503-236-9609",
            "fax_number": "503-236-2906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4531 SE BELMONT ST STE 302",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972151699",
            "telephone_number": "503-236-9609",
            "fax_number": "503-236-2906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLTON",
        "first_name": "NICOLE",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-01-25",
        "last_updated": "2022-06-28",
        "certification_date": "2022-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OR",
            "license": "3983",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2022; 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.