Chad Anderson
Individual provider Active NPI Chiropractor · Brookings, OR
NPI 1902214992 · NPPES record last updated May 20, 2016
Key facts
- NPI
- 1902214992
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 5716 (OR)
- Practice address
- 411 Mill Beach Rd
Ste a
Brookings, OR 97415-9690 - Phone
- (541) 469-2276
- Fax
- (541) 469-0489
- NPI assigned
- Jul 23, 2014
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Chiropractic
- Education
- Other, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
411 Mill Beach Rd
Suite a
Brookings, OR 97415-9690
Phone (541) 469-2276
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OR
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160706001341 | OR | Practitioner - Chiropractic | 7416249875 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5716 | OR | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Anderson Chiropractic, Inc | Chiropractor | Current |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 5716 | OR | Yes |
Addresses
Primary practice location
411 Mill Beach Rd
Ste a
Brookings, OR 97415-9690
Mailing address
PO Box 7967
Brookings, OR 97415-0374
Phone (541) 469-2276
Other providers in Brookings, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 20, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.