Active NPI
Jesse Owen Brockey, D.C.
- Chiropractor
- Warrenton, OR
National Provider Identifier
1942583711
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 5008
- Practice address
- 679 E Harbor Dr
# 140
Warrenton, OR 97146-9717 - Phone
- (503) 861-1661
- Fax
- (503) 861-0254
- NPI assigned
- Sep 27, 2011
- Last updated
- Jun 3, 2016
- 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 | 5008 | OR | Primary |
Addresses
Primary practice location
679 E Harbor Dr
# 140
Warrenton, OR 97146-9717
Mailing address
PO Box 576
Warrenton, OR 97146-0576
Phone (503) 861-1661
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20131126000740 | OR | Practitioner - Chiropractic | 7416183249 |
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Western States College of Chiropractic, 2011
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
PO Box
Suite 576
Warrenton, OR 97146
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5008 | OR | MD | Naturopath |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Milwaukie Chiropractic Center | Chiropractor | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Columbia Pacific Chiropractic
- Chiropractor
- Warrenton, OR
- NPI 1154779791
-
- Chiropractor
- Milwaukie, OR
- NPI 1174564934
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1317081600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1464912000000",
"number": "1942583711",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 576",
"city": "WARRENTON",
"state": "OR",
"postal_code": "971460576",
"telephone_number": "503-861-1661",
"fax_number": "503-861-0254"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "679 E HARBOR DR",
"address_2": "# 140",
"city": "WARRENTON",
"state": "OR",
"postal_code": "971469717",
"telephone_number": "503-861-1661",
"fax_number": "503-861-0254"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROCKEY",
"first_name": "JESSE",
"middle_name": "OWEN",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-09-27",
"last_updated": "2016-06-03",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "OR",
"license": "5008",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Warrenton, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.