NPIMap

Organization Active NPI

Impact Chiropractic

  • Rehabilitation Clinic/Center
  • Portland, OR
National Provider Identifier
1972364735
Registry record updated Jan 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Clinic/CenterTaxonomy code 261QR0400X
Legal business name
IMPACT CHIROPRACTIC
Practice address
18206 SE Stark St
Portland, OR 97233-4863
Phone
(360) 521-5576
NPI assigned
Jan 18, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2024

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

Authorized official

Name
Nam Kim, D.C.NPI 1164820148
Title
President
Phone
(360) 521-5576

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
Rehabilitation Clinic/Center 261QR0400X Primary

Addresses

Primary practice location

18206 SE Stark St
Portland, OR 97233-4863

Mailing address

12535 SE 131St CT
Happy Valley, OR 97086-1684
Phone (360) 521-5576

National Provider Directory

National Provider Directory
Tax ID family
Impact Chiropractic2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

18206 SE Stark St
Portland, OR 97233
Phone (360) 521-5576

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": "1705536000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705536000000",
    "number": "1972364735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12535 SE 131ST CT",
            "city": "HAPPY VALLEY",
            "state": "OR",
            "postal_code": "970861684",
            "telephone_number": "360-521-5576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18206 SE STARK ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972334863",
            "telephone_number": "360-521-5576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMPACT CHIROPRACTIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-18",
        "last_updated": "2024-01-18",
        "certification_date": "2024-01-18",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "NAM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "360-521-5576",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": null,
            "license": null,
            "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 Jan 18, 2024; 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.