Individual provider Active NPI

Jeremy Scott Holbrook, D.C.

  • Chiropractor
  • Bend, OR
National Provider Identifier
1720287808
Registry record updated Jan 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
713750 Issued in OR
Practice address
1551 NE 4TH St
Bend, OR 97701-4241
Phone
(541) 389-9373
Fax
(541) 388-0650
NPI assigned
Jul 17, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 14, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 713750 OR Primary

Addresses

Primary practice location

1551 NE 4TH St
Bend, OR 97701-4241

Mailing address

1551 NE 4TH St
Bend, OR 97701-4241
Phone (541) 389-9373

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080222000353 OR Practitioner - Chiropractic 3173605722 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Western States College of Chiropractic, 2006
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

598 NW Hill St
Suite B
Bend, OR 97703-2970
Phone (541) 639-5389

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
713750ORMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Holbrook Enterprise Inc. Chiropractor CurrentSince Sep 30, 2016 Accepting new patients
Jennifer Finley L.Ac. CurrentSince Dec 28, 2022 Accepting new patients

Locations

598 NW Hill St
Ste B
Bend, OR 97703
Phone (541) 385-7688

1551 NE 4th St
Bend, OR 97701
Phone (541) 318-1000

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1184630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1200268800000",
    "number": "1720287808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1551 NE 4TH ST",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977014241",
            "telephone_number": "541-389-9373",
            "fax_number": "541-388-0650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1551 NE 4TH ST",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977014241",
            "telephone_number": "541-389-9373",
            "fax_number": "541-388-0650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLBROOK",
        "first_name": "JEREMY",
        "middle_name": "SCOTT",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-07-17",
        "last_updated": "2008-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OR",
            "license": "713750",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bend, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2008; 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.