NPIMap

Organization Active NPI

Core Movement Chiropractic LLC

  • Chiropractor
  • West Linn, OR
National Provider Identifier
1760206809
Registry record updated Dec 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
CORE MOVEMENT CHIROPRACTIC LLC
Practice address
21860 Willamette Dr
West Linn, OR 97068-3256
Phone
(503) 650-2394
Fax
(503) 212-3275
NPI assigned
Nov 14, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2024

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

Authorized official

Name
Tristan S Maceiras, DCNPI 1689381451
Title
Owner
Phone
(512) 695-0971

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 5

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X Primary
Neurology ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111NN0400X
Nutrition ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111NN1001X
Radiology ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111NR0200X
Rehabilitation ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111NR0400X

Addresses

Primary practice location

21860 Willamette Dr
West Linn, OR 97068-3256

Mailing address

21860 Willamette Dr
West Linn, OR 97068-3256
Phone (503) 650-2394

Other names 1

  • Gentle Care Chiropracitc Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250430002013 OR Part B Supplier - Clinic/Group Practice 8527584788 Receives reassigned benefits from 2 practitioners
Practice locations: West Linn, OR

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 12

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": "1731542400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734307200000",
    "number": "1760206809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21860 WILLAMETTE DR",
            "city": "WEST LINN",
            "state": "OR",
            "postal_code": "970683256",
            "telephone_number": "503-650-2394",
            "fax_number": "503-212-3275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21860 WILLAMETTE DR",
            "city": "WEST LINN",
            "state": "OR",
            "postal_code": "970683256",
            "telephone_number": "503-650-2394",
            "fax_number": "503-212-3275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORE MOVEMENT CHIROPRACTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-14",
        "last_updated": "2024-12-16",
        "certification_date": "2024-12-16",
        "status": "A",
        "authorized_official_last_name": "MACEIRAS",
        "authorized_official_first_name": "TRISTAN",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "512-695-0971",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "111NN0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor, Neurology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "111NN1001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor, Nutrition",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "111NR0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor, Radiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "111NR0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor, Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gentle Care Chiropracitc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in West Linn, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2024; 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.