Organization Active NPI

CDL Chiropractic Clinic, PC

  • Chiropractor
  • Portland, OR
National Provider Identifier
1912182965
Registry record updated Mar 21, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
273091 Issued in OR
Legal business name
CDL CHIROPRACTIC CLINIC, PC
Practice address
1410 SW Marlow Ave
Portland, OR 97225-5145
Phone
(503) 892-3600
Fax
(503) 892-3070
NPI assigned
Jan 8, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2013

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

Authorized official

Name
Dr. Christine Duggan Lord, D.C.NPI 1205989092
Title
President
Phone
(503) 892-3600

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 273091 OR Primary

Addresses

Primary practice location

1410 SW Marlow Ave
Portland, OR 97225-5145

Mailing address

1410 SW Marlow Ave
Portland, OR 97225-5145
Phone (503) 892-3600

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120323000188 OR Part B Supplier - Clinic/Group Practice 8426218710 Receives reassigned benefits from 1 practitioner
Practice locations: Portland, OR

National Provider Directory

National Provider Directory

Locations

4616 SW Vermont St
Portland, OR 97219
Phone (503) 816-1749

Practitioners & affiliated clinicians

Practitioners 3

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": "1199750400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1363824000000",
    "number": "1912182965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1410 SW MARLOW AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972255145",
            "telephone_number": "503-892-3600",
            "fax_number": "503-892-3070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1410 SW MARLOW AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972255145",
            "telephone_number": "503-892-3600",
            "fax_number": "503-892-3070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CDL CHIROPRACTIC CLINIC, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-08",
        "last_updated": "2013-03-21",
        "status": "A",
        "authorized_official_last_name": "LORD",
        "authorized_official_first_name": "CHRISTINE",
        "authorized_official_middle_name": "DUGGAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "503-892-3600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "OR",
            "license": "273091",
            "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 Mar 21, 2013; 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.