DR. JARED WILSON (NPI# 1104059104) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104059104 |
| Entity Type | Individual |
| Full Name | DR. JARED WILSON |
| Credential | D.C. |
| Practice Address |
498 Harlow Rd Ste 3 Springfield OR 97477-1339 |
| Practice Telephone | 5413411414 |
| Practice Fax Number | 5416538570 |
| Mailing Telephone | 5413411414 |
| Mailing Fax Number | 5416538570 |
| Enumeration Date | 2009-08-25 |
| Last Update Date | 2020-03-24 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 111N00000X | Chiropractor | 3956 | OR | Chiropractic Providers |
| Y | 111NS0005X |
Chiropractor Specialization: Sports Physician |
3956 | OR | Chiropractic Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 500707661 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922350321 | Jared Lane Wilson | Chiropractor | 8611 N Division St Ste A, Spokane, WA 99208-5946 | 2012-10-09 |
| 1699868927 | Jared Paul Wilson | Physician Assistant | 7070 E Drive North, Battle Creek, MI 49014-8562 | 2006-09-30 |
| 1902876667 | Jared K Wilson | Family Medicine | 112 Liberty Sq, Liberty, KY 42539-3392 | 2006-01-25 |
| 1922532977 | Jared Wilson | Internal Medicine | 1501 N Campbell Ave, Room 6336, Tucson, AZ 85724-5040 | 2017-04-17 |
| 1639461304 | Jared Michael Wilson | Anesthesiology | 77 Nealy Ave, Langley Afb Hospital - Anesthesiology Dept, Langley Afb, VA 23665-2040 | 2011-05-12 |
| 1598998353 | Jared A Wilson | Physician Assistant | 1662 Higdon Ferry Road, Ste 300, Hot Springs, AR 71913 | 2009-08-27 |
| 1275748089 | Jared Kent Wilson | Specialist/Technologist | 777 Hospital Way, Building A, Suite 201, Pocatello, ID 83201-5175 | 2007-05-14 |
| Street Address |
498 HARLOW RD STE 3 |
| City | SPRINGFIELD |
| State | OR |
| Zip Code | 97477-1339 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013540285 | Katrina Shaw | Massage Therapist | 498 Harlow Rd Ste 3, Springfield, OR 97477-1339 | 2020-02-17 |
| 1184129694 | Core Strength Chiropractic LLC | Chiropractor | 498 Harlow Rd Ste 3, Springfield, OR 97477-1339 | 2018-03-27 |
| 1336437243 | Caring Hand To Mouth | Dentist | 498 Harlow Rd Ste 3, Springfield, OR 97477-1339 | 2011-07-12 |
| 1831417245 | Statewide Dental Service, PC | Dentist | 498 Harlow Rd Ste 3, Springfield, OR 97477-1339 | 2010-05-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508416140 | Chase Michael Collings | Physician Assistant | 960 N 16th St Ste 303, Springfield, OR 97477 | 2019-09-16 |
| 1174079396 | Amie Flanagan | Occupational Therapy Assistant | 3152 Valentine Court, Springfield, OR 97477 | 2016-08-28 |
| 1609229590 | Kiernan Davis Snedigar | Counselor | 175 W B St Ste J, Springfield, OR 97477 | 2016-07-15 |
| 1578914206 | Ryan James Dixon | Counselor | 1923 Centennial Blvd, Springfield, OR 97477 | 2016-06-23 |
| 1902275464 | Jovonnie Bashaw | Counselor | 1157 5th St, Springfield, OR 97477 | 2015-09-15 |
| 1053759506 | Norco Inc | Durable Medical Equipment & Medical Supplies | 302 Shelley St Ste 7&8, Springfield, OR 97477 | 2013-06-06 |
| 1780931634 | Justin Morris | Pharmacist | 1891 Pioneer Parkway East, Springfield, OR 97477 | 2012-08-09 |
| 1194083105 | Mersedeh Bahr Hosseini | Psychiatry & Neurology | 3311 Riverbend Dr., Neurohospitalists, Springfield, OR 97477 | 2012-04-26 |
| 1962769679 | Hiro Kawata | Internal Medicine | 3311 Rierbend Dr., Springfield, OR 97477 | 2012-04-19 |
| 1659662823 | Wendy A Teigen | Counselor | 3995 Marcola Rd., Springfield, OR 97477 | 2011-04-22 |
| Find all providers in zip 97477 | ||||
| Taxonomy Code | 111NS0005X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| Specialization | Sports Physician |
| A sports chiropractor is uniquely trained to provide care and treatment of injuries or illness resulting from sports and physical fitness activities. Doctors of Chiropractic with the Diplomate American Chiropractic Board of Sports Physicians (DACBSP) or the Certified Chiropractic Sports Physician (CCSP), sport specialty certifications from the American Chiropractic Board of Sports Physicians, have advanced training in the assessment, management and rehabilitation of sports related injuries. Extremity care, rehabilitation and soft tissue procedures are common skills utilized by these doctors. The specialty training covers a broad spectrum from the pediatric athlete to professional and Olympic athletes, and everything in between, using a variety of techniques and modalities. |
| Notes: Source: American Chiropractic Board of Sports Physicians, 2009 [7/1/2009: definition added] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679695878 | Douglas Edward Scott | Chiropractor | 3734 South Ave Ste A, Springfield, MO 65807-5291 | 2007-04-06 |
| 1043296726 | Brian Scott Dixon | Chiropractor | 90 Berkshire Ave, Springfield, MA 01109-1709 | 2005-12-15 |
| 1902804024 | Susan Draper White | Chiropractor | 6803 C St, Springfield, OR 97478-7389 | 2005-07-12 |
| 1184129694 | Core Strength Chiropractic LLC | Chiropractor | 498 Harlow Rd Ste 3, Springfield, OR 97477-1339 | 2018-03-27 |
| 1952757353 | Abigail Emery | Chiropractor | 3021 E Sunshine St, Springfield, MO 65804-2052 | 2016-05-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801381140 | Tyler Miller | Chiropractor | 455 Nw Wanapa St, Cascade Locks, OR 97014 | 2018-06-28 |
| 1952848764 | Cooper Jay Adams | Chiropractor | 6046 E Burnside St, Portland, OR 97215-1268 | 2017-01-31 |
| 1871039768 | Sissel Holloway | Chiropractor | 501 Portway Ave Ste 203, Hood River, OR 97031-1288 | 2017-01-16 |
| 1992172977 | Whittaker Wellness and Performance Center | Chiropractor | 1000 Sw Broadway, Suite 1210, Portland, OR 97205-3003 | 2015-08-26 |
| 1588079776 | Function Performance Sport Chiropractic LLC | Chiropractor | 502 7th St Ste 100, Oregon City, OR 97045-2246 | 2014-06-25 |
| 1295162006 | Blake Testa | Chiropractor | 2663 12th St Se, Salem, OR 97302-2154 | 2013-10-11 |
| 1396182580 | Katherine M Sill | Chiropractor | 2820 E Main St, Hillsboro, OR 97123-7068 | 2013-05-28 |
| 1376883728 | Halsy James Carter | Chiropractor | 12700swnorth Dakota St 180, Tigard, OR 97223-0802 | 2013-02-21 |
| 1043571136 | Adam Goulet | Chiropractor | 1501 N Aisworth, Portland, OR 97217 | 2012-06-05 |
| 1275804171 | Dewar Chiropractic, LLC | Chiropractor | 1385 Se 1st Ave Ste 102, Canby, OR 97013-6767 | 2012-01-24 |
| Find all providers with the same taxonomy | ||||
| City | SPRINGFIELD |
| Zip Code | 97477 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.