SHERIDAN FAMILY CHIROPRACTIC PC (NPI# 1790951440) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790951440 |
| Entity Type | Organization |
| Organization Name | SHERIDAN FAMILY CHIROPRACTIC PC |
| Practice Address |
639 W Main Sheridan OR 97378 |
| Mailing Address |
Po Box 37 Sheridan OR 97378-0037 |
| Practice Telephone | 5038433888 |
| Practice Fax Number | 5038434366 |
| Mailing Telephone | 5038433888 |
| Mailing Fax Number | 5038434366 |
| Enumeration Date | 2008-05-02 |
| Last Update Date | 2015-06-27 |
| Authorized Official Name | DR. KENNETH A KELLEY (OWNER) |
| Authorized Official Telephone | 5038433888 |
| Authorized Official Credential | DC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | 651343 | OR | Chiropractic Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | PERMANENTE | 112941 | 01 |
| REGENCE BC BS | 059489000 | 01 |
| Street Address |
639 W MAIN |
| City | SHERIDAN |
| State | OR |
| Zip Code | 97378 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902878333 | Kenneth A Kelley | Chiropractor | 639 W Main, Sheridan, OR 97378 | 2006-02-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386757193 | Andrew Barnes Grasley | General Practice | 2702 Sw Ballston Road, Sheridan, OR 97378 | 2006-08-16 |
| 1265959563 | Bettina Tamice Moore | Counselor | 901 W Main St, Sheridan, OR 97378-1003 | 2017-08-28 |
| 1467837344 | Cody Charron | Dentist | 411 W Main St, Sheridan, OR 97378-1117 | 2015-07-21 |
| 1801918255 | Kenneth G Mize Dmdpc | Dentist | 411 W Main St, Sheridan, OR 97378-1117 | 2007-04-05 |
| 1255338638 | Kenneth G Mize | Dentist | 411 W Main St, Sheridan, OR 97378-1117 | 2005-06-30 |
| 1689047680 | Thunderstruck Farms Inc. | Chiropractor | 639 W Main St, Sheridan, OR 97378-1121 | 2015-11-12 |
| 1013390939 | Tina Hargrove | Chiropractor | 639 W Main St, Sheridan, OR 97378-1121 | 2015-07-09 |
| 1598951634 | Julie Lynn Detamore | Acupuncturist | 552 Nw Evans St, Sheridan, OR 97378-1208 | 2007-09-21 |
| 1376076331 | Timothy Roaden | Peer Specialist | 356 Ne Faulconer Ct, Sheridan, OR 97378-1255 | 2017-04-06 |
| 1932238086 | Nancy Nunley | Registered Nurse | 220 Sw Jefferson St, Sheridan, OR 97378-1720 | 2007-03-05 |
| Find all providers in zip 97378 | ||||
| Taxonomy Code | 111N00000X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811471220 | Collin Drew Redinger | Chiropractor | 528 Coffeen Ave, Sheridan, WY 82801-5312 | 2018-09-21 |
| 1487044855 | Zachary Winkelmann | Chiropractor | 850 Val Vista St Ste A, Sheridan, WY 82801-3667 | 2015-01-23 |
| 1811220064 | Colin Eugene Hardy | Chiropractor | 24 E Grinnell Plz, Sheridan, WY 82801-3936 | 2009-09-04 |
| 1720235286 | Integrative Health, LLC | Chiropractor | 856 Coffeen Ave Ste 102, Sheridan, WY 82801-5318 | 2008-08-26 |
| 1669646022 | Betty L. Mitchell | Chiropractor | 214 W Loucks St, Sheridan, WY 82801-4209 | 2008-04-16 |
| 1003000688 | Husske Chiropractic Clinic | Chiropractor | 1265 Coffeen Ave, Sheridan, WY 82801-5325 | 2007-08-28 |
| 1255483368 | Buchanan Chiropractic PC | Chiropractor | 50 E Brundage Street, Sheridan, WY 82801-6353 | 2007-01-17 |
| 1003988213 | Patrick J Kirsch | Chiropractor | 25 E Alger St, Sheridan, WY 82801-3911 | 2006-11-14 |
| 1003995184 | Betty L Mitchell Dc PC | Chiropractor | 214 W Loucks, Sheridan, WY 82801 | 2006-11-02 |
| 1699856807 | Brian A Husske | Chiropractor | 1265 Coffeen Avenue, Sheridan, WY 82801 | 2006-10-17 |
| Find all providers in SHERIDAN | ||||
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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.