Organization Active NPI

Willamette Valley Spine Solutions, PC

  • Chiropractor
  • Albany, OR
National Provider Identifier
1609248624
Registry record updated Oct 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4082 Issued in OR
Legal business name
WILLAMETTE VALLEY SPINE SOLUTIONS, PC
Practice address
1117 Pacific Blvd SE
Albany, OR 97321-3154
Phone
(541) 928-1010
Fax
(541) 928-1093
NPI assigned
Oct 29, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2015

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

Authorized official

Name
Dr. Kevin M Ross, DCNPI 1720384126
Title
Owner/President
Phone
(541) 928-1010

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
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 4082 OR Primary

Addresses

Primary practice location

1117 Pacific Blvd SE
Albany, OR 97321-3154

Mailing address

1117 Pacific Blvd SE
Albany, OR 97321-3154
Phone (541) 928-1010

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160516000990 OR Part B Supplier - Clinic/Group Practice 0345539391 Receives reassigned benefits from 2 practitioners
Practice locations: Albany, OR

National Provider Directory

National Provider Directory

Locations

1249 Pacific Blvd SE
Albany, OR 97321
Phone (541) 704-0633

Practitioners & affiliated clinicians

Practitioners 3

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": "1446076800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1446076800000",
    "number": "1609248624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1117 PACIFIC BLVD SE",
            "city": "ALBANY",
            "state": "OR",
            "postal_code": "973213154",
            "telephone_number": "541-928-1010",
            "fax_number": "541-928-1093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1117 PACIFIC BLVD SE",
            "city": "ALBANY",
            "state": "OR",
            "postal_code": "973213154",
            "telephone_number": "541-928-1010",
            "fax_number": "541-928-1093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLAMETTE VALLEY SPINE SOLUTIONS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-29",
        "last_updated": "2015-10-29",
        "status": "A",
        "authorized_official_last_name": "ROSS",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "541-928-1010",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "OR",
            "license": "4082",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albany, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2015; 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.