Active NPI
John Paul Brotzman, D.C.
- Chiropractor
- Portland, OR
National Provider Identifier
1669636098
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 3678
- Practice address
- 4445 SW Barbur Blvd
Suite 104
Portland, OR 97239-4047 - Phone
- (150) 322-6450
- NPI assigned
- Jul 15, 2008
- Last updated
- Jul 15, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 3678 | OR | Primary |
Addresses
Primary practice location
4445 SW Barbur Blvd
Suite 104
Portland, OR 97239-4047
Mailing address
PO Box 2576
Portland, OR 97208-2576
Phone (150) 333-3261
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
| License | State | Type | Specialty |
|---|---|---|---|
| 3678 | OR | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1216080000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1216080000000",
"number": "1669636098",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2576",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972082576",
"telephone_number": "150-333-3261"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4445 SW BARBUR BLVD",
"address_2": "SUITE 104",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972394047",
"telephone_number": "150-322-6450"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROTZMAN",
"first_name": "JOHN",
"middle_name": "PAUL",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-07-15",
"last_updated": "2008-07-15",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "OR",
"license": "3678",
"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 Jul 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.