Active NPI
John Clayton Stady, CHIROPRACTOR DC
- Chiropractor
- Beaverton, OR
National Provider Identifier
1780720656
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 2051
- Practice address
- 12775 SW Broadway
Beaverton, OR 97005 - Phone
- (503) 644-3022
- NPI assigned
- Jan 29, 2007
- Last updated
- Jul 8, 2007
- Sex
- Male
- 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 | 2051 | OR | Primary |
Addresses
Primary practice location
12775 SW Broadway
Beaverton, OR 97005
Mailing address
12775 SW Broadway
Beaverton, OR 97005
Phone (503) 644-3022
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| John Stady | Chiropractor | Current | Accepting new patients |
Locations
12775 SW Broadway St
Beaverton, OR 97005
Phone (503) 644-3022
Organizations & group practices 1
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": "1170028800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1780720656",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12775 SW BROADWAY",
"city": "BEAVERTON",
"state": "OR",
"postal_code": "97005",
"telephone_number": "503-644-3022",
"fax_number": "503-644-3022"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12775 SW BROADWAY",
"city": "BEAVERTON",
"state": "OR",
"postal_code": "97005",
"telephone_number": "503-644-3022"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STADY",
"first_name": "JOHN",
"middle_name": "CLAYTON",
"credential": "CHIROPRACTOR DC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-29",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "OR",
"license": "2051",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Beaverton, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.