Organization Active NPI

McCleery Chiropractic Health Centre PC

  • Chiropractor
  • Bend, OR
National Provider Identifier
1902890098
Registry record updated Nov 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
27 1294 Issued in OR
Legal business name
MCCLEERY CHIROPRACTIC HEALTH CENTRE PC
Practice address
404 NE Greenwood Ave
Bend, OR 97701-4608
Phone
(541) 389-7103
Fax
(541) 389-1173
NPI assigned
Sep 6, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2015

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

Authorized official

Name
Mrs. Samantha S McCleery
Title
Clinic Administrator
Phone
(541) 389-7103

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 27 1294 OR Primary

Addresses

Primary practice location

404 NE Greenwood Ave
Bend, OR 97701-4608

Mailing address

404 NE Greenwood Ave
Bend, OR 97701-4608
Phone (541) 389-7103

Other identifiers 1

IdentifierTypeStateIssuer
005054001OtherORREGENCE BLUE CROSS ID

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110517000905 OR Part B Supplier - Clinic/Group Practice 5496931966 Receives reassigned benefits from 1 practitioner
Practice locations: Bend, OR

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1125964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1448323200000",
    "number": "1902890098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "404 NE GREENWOOD AVE",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977014608",
            "telephone_number": "541-389-7103",
            "fax_number": "541-389-1173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "404 NE GREENWOOD AVE",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977014608",
            "telephone_number": "541-389-7103",
            "fax_number": "541-389-1173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCCLEERY CHIROPRACTIC HEALTH CENTRE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-06",
        "last_updated": "2015-11-24",
        "status": "A",
        "authorized_official_last_name": "MCCLEERY",
        "authorized_official_first_name": "SAMANTHA",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "CLINIC ADMINISTRATOR",
        "authorized_official_telephone_number": "541-389-7103",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "OR",
            "license": "27 1294",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUE CROSS ID",
            "identifier": "005054001",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bend, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2015; 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.