Robert Owen Dietz, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

273650 Issued in OR

Practice address

1217 NE Burnside Rd
Suite 502
Gresham, OR 97030-6722

Phone

(503) 492-3910

Fax

(503) 492-3905

NPI assigned

Oct 2, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Specialty

Chiropractic

Education

Other, 1989

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Valley Chiropractic LLC

  • Chiropractor
  • Molalla, OR
  • NPI 1710651500
  Medicare reassignment NPD
• Gresham Therapeutic Massage Center

  • Specialist
  • Gresham, OR
  • NPI 1033317474
  NPD (past)
• Molalla Chiropractic & Naturopathic Clinic P.C.

  • Clinic/Center
  • Molalla, OR
  • NPI 1396050340
  NPD (past)

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

{
    "created_epoch": "1191283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191283200000",
    "number": "1992992077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1217 NE BURNSIDE RD",
            "address_2": "SUITE 502",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970306722",
            "telephone_number": "503-492-3910",
            "fax_number": "503-492-3905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1217 NE BURNSIDE RD",
            "address_2": "SUITE 502",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970306722",
            "telephone_number": "503-492-3910",
            "fax_number": "503-492-3905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIETZ",
        "first_name": "ROBERT",
        "middle_name": "OWEN",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-10-02",
        "last_updated": "2007-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OR",
            "license": "273650",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "273650",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Talia Rose Dewolfe
• Amber Dawn Deyo
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• Marlene Diaz Aguilar
• Kylie Dieringer
• Sarah Elizabeth Dilday, PWS/QMHA-I
• Kamilah Dillard
• John William Dillow, BA
• Division Family Dental LLC
• Brent Alan Dixson, DC

• Chiropractor in Gresham, OR
• Providers in Gresham, OR by specialty
• Chiropractor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2007; 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.

Verify at the official NPI Registry.