NPIMap

Organization Active NPI

Premier Chiropractic PC

  • Chiropractor
  • Salem, OR
National Provider Identifier
1659882645
Registry record updated Oct 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
PREMIER CHIROPRACTIC PC
Practice address
3000 Market St NE Ste 268
Salem, OR 97301-1809
Phone
(503) 584-1620
Fax
(503) 990-6985
NPI assigned
Oct 17, 2017
Last updated
Oct 17, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2017

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

Authorized official

Name
Dr. David Street, DCNPI 1114358470
Title
Secretary
Phone
(805) 400-5259

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X Primary

Addresses

Primary practice location

3000 Market St NE Ste 268
Salem, OR 97301-1809

Mailing address

3000 Market St NE Ste 268
Salem, OR 97301-1809
Phone (503) 584-1620

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20171108002246 OR Part B Supplier - Clinic/Group Practice 1355607201 Receives reassigned benefits from 5 practitioners
Practice locations: Salem, OR

National Provider Directory

National Provider Directory

Locations

3000 Market St NE
Ste 266
Salem, OR 97301
Phone (503) 584-1620

3000 Market St NE
Ste 541
Salem, OR 97301
Phone (503) 584-1620

Practitioners & affiliated clinicians

Practitioners 6

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": "1508198400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1508198400000",
    "number": "1659882645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3000 MARKET ST NE STE 268",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973011809",
            "telephone_number": "503-584-1620",
            "fax_number": "503-990-6985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 MARKET ST NE STE 268",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973011809",
            "telephone_number": "503-584-1620",
            "fax_number": "503-990-6985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER CHIROPRACTIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-17",
        "last_updated": "2017-10-17",
        "status": "A",
        "authorized_official_last_name": "STREET",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "805-400-5259",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2017; 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.