Organization Active NPI

Aspen Chiropractic P.C.

  • Chiropractor
  • Sutherlin, OR
National Provider Identifier
1902335763
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
ASPEN CHIROPRACTIC P.C.
Practice address
325 Park Hill LN
Sutherlin, OR 97479-9022
Phone
(541) 802-1040
Fax
(541) 802-1042
NPI assigned
Jun 6, 2017
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Dr. Christopher Reneau, DC
Title
Chiropractor/Owner
Phone
(541) 802-1040

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X Primary
Primary Care Clinic/Center 261QP2300X 5535 OR

Addresses

Primary practice location

325 Park Hill LN
Sutherlin, OR 97479-9022

Mailing address

325 Park Hill LN
Sutherlin, OR 97479-9022
Phone (541) 802-1040

Other identifiers 1

IdentifierTypeStateIssuer
500663209MedicaidOR

National Provider Directory

National Provider Directory

Locations

2569 NW Edenbower Blvd
Roseburg, OR 97471
Phone (541) 672-4807

325 Park Hill Ln
Sutherlin, OR 97479
Phone (541) 802-1040

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

NPI Registry JSON

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

{
    "created_epoch": "1496707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1902335763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 PARK HILL LN",
            "city": "SUTHERLIN",
            "state": "OR",
            "postal_code": "974799022",
            "telephone_number": "541-802-1040",
            "fax_number": "541-802-1042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 PARK HILL LN",
            "city": "SUTHERLIN",
            "state": "OR",
            "postal_code": "974799022",
            "telephone_number": "541-802-1040",
            "fax_number": "541-802-1042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASPEN CHIROPRACTIC P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-06",
        "last_updated": "2022-07-21",
        "certification_date": "2021-03-05",
        "status": "A",
        "authorized_official_last_name": "RENEAU",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "CHIROPRACTOR/OWNER",
        "authorized_official_telephone_number": "541-802-1040",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "OR",
            "license": "5535",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500663209",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sutherlin, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.