Individual provider Active NPI

Kevin M Ross, D.C.

  • Chiropractor
  • Albany, OR
National Provider Identifier
1720384126
Registry record updated Sep 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4082 Issued in OR
Practice address
1249 Pacific Blvd SE
Albany, OR 97321-4824
Phone
(541) 928-1010
Fax
(541) 928-1093
NPI assigned
Feb 1, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4082 OR Primary

Addresses

Primary practice location

1249 Pacific Blvd SE
Albany, OR 97321-4824

Mailing address

1249 Pacific Blvd SE
Albany, OR 97321-4824
Phone (541) 928-1010

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110624000389 OR Practitioner - Chiropractic 2466630314 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Western States College of Chiropractic, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1249 Pacific Blvd SE
Albany, OR 97321-4824
Phone (541) 928-1010

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Willamette Valley Spine Solutions, PC Chiropractor CurrentSince Jan 14, 2016 Accepting new patients
Heresco Chiropractic and Associates PC Chiropractor PastSince Sep 1, 1999 Accepting new patients

Locations

1117 Pacific Blvd SE
Albany, OR 97321
Phone (541) 928-1010

1249 Pacific Blvd SE
Albany, OR 97321
Phone (541) 704-0633

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": "1296518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758240000000",
    "number": "1720384126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1249 PACIFIC BLVD SE",
            "city": "ALBANY",
            "state": "OR",
            "postal_code": "973214824",
            "telephone_number": "541-928-1010",
            "fax_number": "541-928-1093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1249 PACIFIC BLVD SE",
            "city": "ALBANY",
            "state": "OR",
            "postal_code": "973214824",
            "telephone_number": "541-928-1010",
            "fax_number": "541-928-1093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSS",
        "first_name": "KEVIN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-02-01",
        "last_updated": "2025-09-19",
        "certification_date": "2025-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OR",
            "license": "4082",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albany, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2025; 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.