Individual provider Active NPI

Jeffrey Ray Tornabene, D.C.

  • Chiropractor
  • Eagle Point, OR
National Provider Identifier
1679916308
Registry record updated Dec 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5142 Issued in OR
Practice address
1296 S Shasta Ave
Eagle Point, OR 97524-8521
Phone
(541) 830-4325
Fax
(541) 826-2620
NPI assigned
Apr 11, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 5142 OR Primary

Addresses

Primary practice location

1296 S Shasta Ave
Eagle Point, OR 97524-8521

Mailing address

1296 S Shasta Ave
Eagle Point, OR 97524-8521
Phone (541) 830-4325

Other identifiers 1

IdentifierTypeStateIssuer
500674258MedicaidOR

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130621000321 OR Practitioner - Chiropractic 9335388446 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Complete Care Chiropractic and MassageGroup PAC ID 0547300295, 3 clinicians

Practice addresses (Care Compare)

1296 S Shasta Ave
Eagle Point, OR 97524-8521
Phone (541) 830-4325

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Complete Care Chiropractic and Massage CurrentSince Apr 17, 2013 Accepting new patients
Complete Integrative Care, LLC PastSince Apr 17, 2013 Accepting new patients

Locations

1296 S Shasta Ave
Eagle Point, OR 97524
Phone (541) 830-4325

3132 State St
Ste 110
Medford, OR 97504
Phone (541) 732-1686

Interoperability endpoints

  • Direct secure messaging: jeffrey.tornabene.1@12515.direct.athenahealth.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1365638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480982400000",
    "number": "1679916308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1296 S SHASTA AVE",
            "city": "EAGLE POINT",
            "state": "OR",
            "postal_code": "975248521",
            "telephone_number": "541-830-4325",
            "fax_number": "541-826-2620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1296 S SHASTA AVE",
            "city": "EAGLE POINT",
            "state": "OR",
            "postal_code": "975248521",
            "telephone_number": "541-830-4325",
            "fax_number": "541-826-2620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TORNABENE",
        "first_name": "JEFFREY",
        "middle_name": "RAY",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-11",
        "last_updated": "2016-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OR",
            "license": "5142",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500674258",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Eagle Point, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.