Active NPI
Megan Angeline Reid Gomez, DC
- Chiropractor
- Gresham, OR
National Provider Identifier
1710414420
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 5819
- Practice address
- 1217 NE Burnside Rd
Ste 301
Gresham, OR 97030-6722 - Phone
- (503) 492-2625
- NPI assigned
- May 12, 2017
- Sex
- Female
- 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 | 5819 | OR | Primary |
Addresses
Primary practice location
1217 NE Burnside Rd
Ste 301
Gresham, OR 97030-6722
Mailing address
1217 NE Burnside Rd
Ste 301
Gresham, OR 97030
Phone (503) 492-2625
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013289735 | Other | OR | TYPE 2 NPI |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5819 | OR | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1494547200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1502236800000",
"number": "1710414420",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1217 NE BURNSIDE RD",
"address_2": "STE 301",
"city": "GRESHAM",
"state": "OR",
"postal_code": "97030",
"telephone_number": "503-492-2625"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1217 NE BURNSIDE RD",
"address_2": "STE 301",
"city": "GRESHAM",
"state": "OR",
"postal_code": "970306722",
"telephone_number": "503-492-2625"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOMEZ",
"first_name": "MEGAN",
"middle_name": "ANGELINE REID",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-05-12",
"last_updated": "2017-08-09",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "OR",
"license": "5819",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TYPE 2 NPI",
"identifier": "1013289735",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Gresham, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.