Organization Active NPI

Function Performance Sport Chiropractic LLC

  • Sports Physician Chiropractor
  • Oregon City, OR
National Provider Identifier
1588079776
Registry record updated Feb 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Physician ChiropractorTaxonomy code 111NS0005X
License
3898 Issued in OR
Legal business name
FUNCTION PERFORMANCE SPORT CHIROPRACTIC LLC
Practice address
502 7TH St Ste 100
Oregon City, OR 97045-2246
Phone
(503) 730-2788
Fax
(503) 862-5043
NPI assigned
Jun 25, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2020

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

Authorized official

Name
Ben Aaron Hokenson, D.C.NPI 1639318686
Title
Doctor
Phone
(503) 730-2788

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Physician ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111NS0005X 3898 OR Primary

Addresses

Primary practice location

502 7TH St Ste 100
Oregon City, OR 97045-2246

Mailing address

502 7TH St
Oregon City, OR 97045-2246
Phone (503) 730-7888

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200227000102 OR Part B Supplier - Clinic/Group Practice 2769819085 Receives reassigned benefits from 2 practitioners
Practice locations: Oregon City, OR

National Provider Directory

National Provider Directory

Locations

502 7th St
Ste 100
Oregon City, OR 97045
Phone (503) 730-2788

502 7th St
Oregon City, OR 97045

512 7th St
Oregon City, OR 97045
Phone (503) 730-2788

275 Beavercreek Rd
#C141
Oregon City, OR 97045
Phone (503) 730-2788

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1403654400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1582502400000",
    "number": "1588079776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "502 7TH ST",
            "city": "OREGON CITY",
            "state": "OR",
            "postal_code": "970452246",
            "telephone_number": "503-730-7888",
            "fax_number": "503-862-5043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "502 7TH ST STE 100",
            "city": "OREGON CITY",
            "state": "OR",
            "postal_code": "970452246",
            "telephone_number": "503-730-2788",
            "fax_number": "503-862-5043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FUNCTION PERFORMANCE SPORT CHIROPRACTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-25",
        "last_updated": "2020-02-24",
        "certification_date": "2020-02-24",
        "status": "A",
        "authorized_official_last_name": "HOKENSON",
        "authorized_official_first_name": "BEN",
        "authorized_official_middle_name": "AARON",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "503-730-2788",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor, Sports Physician",
            "state": "OR",
            "license": "3898",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oregon City, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.