NPIMap

Organization Active NPI

Mississippi Chiropractic, P.C.

  • Chiropractor
  • Portland, OR
National Provider Identifier
1841353315
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3456 Issued in OR
Legal business name
MISSISSIPPI CHIROPRACTIC, P.C.
Practice address
3737 N Mississippi Ave
Portland, OR 97227-1158
Phone
(503) 467-4511
NPI assigned
Dec 18, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Richard Clark Pitcairn, D.C.NPI 1861553414
Title
President
Phone
(503) 467-4511

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 3456 OR Primary

Addresses

Primary practice location

3737 N Mississippi Ave
Portland, OR 97227-1158

Mailing address

3737 N Mississippi Ave
Portland, OR 97227-1158
Phone (503) 467-4511

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090113000546 OR Part B Supplier - Clinic/Group Practice 1951464254 Receives reassigned benefits from 1 practitioner
Practice locations: Portland, OR

National Provider Directory

National Provider Directory

Locations

3737 N Mississippi Ave
Portland, OR 97227
Phone (503) 467-4511

Practitioners & affiliated clinicians

Practitioners 8

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": "1166400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1841353315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3737 N MISSISSIPPI AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972271158",
            "telephone_number": "503-467-4511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3737 N MISSISSIPPI AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972271158",
            "telephone_number": "503-467-4511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISSISSIPPI CHIROPRACTIC, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PITCAIRN",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "CLARK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "503-467-4511",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "OR",
            "license": "3456",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.