Active Chiropractic and Rehabilitation, LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

ACTIVE CHIROPRACTIC AND REHABILITATION, LLC

Practice address

238 SE Washington St Ste B
Hillsboro, OR 97123-4279

Phone

(503) 648-1088

Fax

(503) 648-0748

NPI assigned

Aug 13, 2010

Last updated

Aug 13, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Patrick D Bourlon, DCNPI 1710056791

Title

Owner/Sole Member

Phone

(503) 648-1088

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Patrick Denis Bourlon, D.C

  • Chiropractor
  • Hillsboro, OR
  • NPI 1710056791
  Medicare reassignment NPD Authorized official
• William Kenneth Plewes, D.C.

  • Chiropractor
  • Hillsboro, OR
  • NPI 1730231846
  NPD (past)

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

{
    "created_epoch": "1281657600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1281657600000",
    "number": "1861707879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "238 SE WASHINGTON ST STE B",
            "city": "HILLSBORO",
            "state": "OR",
            "postal_code": "971234279",
            "telephone_number": "503-648-1088",
            "fax_number": "503-648-0748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "238 SE WASHINGTON ST STE B",
            "city": "HILLSBORO",
            "state": "OR",
            "postal_code": "971234279",
            "telephone_number": "503-648-1088",
            "fax_number": "503-648-0748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACTIVE CHIROPRACTIC AND REHABILITATION, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-13",
        "last_updated": "2010-08-13",
        "status": "A",
        "authorized_official_last_name": "BOURLON",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER/SOLE MEMBER",
        "authorized_official_telephone_number": "503-648-1088",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WASHINGTON STATE LABOR",
            "identifier": "0147111",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "023051002",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Hillsboro, OR
• Providers in Hillsboro, OR by specialty
• Chiropractor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2010; 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.