NPIMap

Organization Active NPI

Elite Health Care Dba Elite Chiropractic and Wellness Center

Doing business as Elite Chiropractic and Wellness Center

  • Chiropractor
  • Gresham, OR
National Provider Identifier
1578701082
Registry record updated Jul 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3726 Issued in OR
Legal business name
ELITE HEALTH CARE DBA ELITE CHIROPRACTIC AND WELLNESS CENTER
Doing business as
Elite Chiropractic and Wellness Center
Practice address
23440 SE Stark St
Gresham, OR 97030-2961
Phone
(503) 489-6245
Fax
(503) 489-0552
NPI assigned
Jan 22, 2009
Last updated
Jul 20, 2011By the provider in NPPES
Organization subpart
Yes
Parent organization
DR. KENNETH WECKER ELITE HEALTH CAREAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 20, 2011

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

Authorized official

Name
Mrs. Heidi A Walter
Title
Office Manager
Phone
(503) 489-6245

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X 3726 OR Primary

Addresses

Primary practice location

23440 SE Stark St
Gresham, OR 97030-2961

Mailing address

23440 SE Stark St
Gresham, OR 97030-2961
Phone (503) 489-6245

Other identifiers 1

IdentifierTypeStateIssuer
1023137585OtherORNPI OF PROVIDER

Other names 1

  • Elite Chiropractic and Wellness Center Doing business as

National Provider Directory

National Provider Directory
Part of
Elite Health Care Dba Elite Chiropractic and Wellness Center

Locations

23440 SE Stark St
Gresham, OR 97030
Phone (503) 489-6245

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1232582400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1311120000000",
    "number": "1578701082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23440 SE STARK ST",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970302961",
            "telephone_number": "503-489-6245",
            "fax_number": "503-489-0552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23440 SE STARK ST",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970302961",
            "telephone_number": "503-489-6245",
            "fax_number": "503-489-0552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE HEALTH CARE DBA ELITE CHIROPRACTIC AND WELLNESS CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DR. KENNETH WECKER ELITE HEALTH CARE",
        "enumeration_date": "2009-01-22",
        "last_updated": "2011-07-20",
        "status": "A",
        "authorized_official_last_name": "WALTER",
        "authorized_official_first_name": "HEIDI",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "503-489-6245",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "OR",
            "license": "3726",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI OF PROVIDER",
            "identifier": "1023137585",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Elite Chiropractic and Wellness Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Gresham, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2011; 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.