Individual provider Active NPI

Megan Bodnar, DC

  • Chiropractor
  • Portland, OR
National Provider Identifier
1568416501
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5877 Issued in OR
Practice address
333 NE Russell St Ste 200
Portland, OR 97212-3762
Phone
(503) 289-1390
NPI assigned
May 22, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 08002257A IN
Chiropractor 111N00000X 5877 OR Primary

Addresses

Primary practice location

333 NE Russell St Ste 200
Portland, OR 97212-3762

Mailing address

333 NE Russell St Ste 200
Portland, OR 97212-3762
Phone (503) 289-1390

Other practice location 1

1321 Unity Pl
Suite A
Lafayette, IN 47905-5774
Phone (765) 446-2450

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
08002257AINMDChiropractor
5877ORMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Roccwell, LLC Past Accepting new patients

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": "1148256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1568416501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 NE RUSSELL ST STE 200",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972123762",
            "telephone_number": "503-289-1390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 NE RUSSELL ST STE 200",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972123762",
            "telephone_number": "503-289-1390"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1321 Unity Pl",
            "address_2": "Suite A",
            "address_purpose": "LOCATION",
            "city": "Lafayette",
            "state": "IN",
            "postal_code": "479055774",
            "country_code": "US",
            "telephone_number": "765-446-2450",
            "fax_number": "765-446-1083",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BODNAR",
        "first_name": "MEGAN",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-22",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IN",
            "license": "08002257A",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OR",
            "license": "5877",
            "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 Mar 17, 2018; 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.