NPIMap

Organization Active NPI

Dyson Family Chiropractic Center, P.C.

  • Chiropractor
  • Salem, OR
National Provider Identifier
1720110794
Registry record updated Sep 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3189 Issued in OR
Legal business name
DYSON FAMILY CHIROPRACTIC CENTER, P.C.
Practice address
1295 Wallace Rd NW
Salem, OR 97304-3007
Phone
(503) 361-3949
NPI assigned
Mar 12, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2012

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

Authorized official

Name
Dr. James G. Dyson, D.C.NPI 1457333833
Title
President
Phone
(503) 361-3949

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 3189 OR Primary

Addresses

Primary practice location

1295 Wallace Rd NW
Salem, OR 97304-3007

Mailing address

1295 Wallace Rd NW
Salem, OR 97304-3007
Phone (503) 361-3949

Other identifiers 1

IdentifierTypeStateIssuer
234885MedicaidOR

Other names 1

  • Advanced Chiropractic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080319000419 OR Part B Supplier - Clinic/Group Practice 0648356469 Receives reassigned benefits from 1 practitioner
Practice locations: Salem, OR

National Provider Directory

National Provider Directory

Locations

1295 Wallace Rd NW
Salem, OR 97304
Phone (503) 361-3949

Practitioners & affiliated clinicians

Practitioners 5

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": "1173657600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1347408000000",
    "number": "1720110794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1295 WALLACE RD NW",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973043007",
            "telephone_number": "503-361-3949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1295 WALLACE RD NW",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973043007",
            "telephone_number": "503-361-3949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DYSON FAMILY CHIROPRACTIC CENTER, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-12",
        "last_updated": "2012-09-12",
        "status": "A",
        "authorized_official_last_name": "DYSON",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "G.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "503-361-3949",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "OR",
            "license": "3189",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "234885",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advanced Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Sep 12, 2012; 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.