Active NPI
Todd Dalyn Thistle, D.C.
- Chiropractor
- Portland, OR
National Provider Identifier
1891959342
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 3805
- Practice address
- 15895 SW 72ND Ave
Suite 120
Portland, OR 97224-7977 - Phone
- (503) 430-1952
- Fax
- (503) 747-0913
- NPI assigned
- Jul 14, 2008
- 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 | 3805 | OR | Primary |
Addresses
Primary practice location
15895 SW 72ND Ave
Suite 120
Portland, OR 97224-7977
Mailing address
15895 SW 72ND Ave
Suite 120
Portland, OR 97224-7977
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3805 | OR | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mja Health Services, Inc. | Chiropractor | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Chiropractor
- Portland, OR
- NPI 1548246663
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1215993600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1452124800000",
"number": "1891959342",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15895 SW 72ND AVE",
"address_2": "SUITE 120",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972247977"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15895 SW 72ND AVE",
"address_2": "SUITE 120",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972247977",
"telephone_number": "503-430-1952",
"fax_number": "503-747-0913"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THISTLE",
"first_name": "TODD",
"middle_name": "DALYN",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-07-14",
"last_updated": "2016-01-07",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "OR",
"license": "3805",
"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 Jan 7, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.