ILLUMINATION ROCK INTEGRATIVE MEDICINE, LLC – NPI #1356905855
Clinic/Center
A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).
ILLUMINATION ROCK INTEGRATIVE MEDICINE, LLC is an AHC clinic located in PORTLAND, OR. NPPES has assigned the NPI number 1356905855 to ILLUMINATION ROCK INTEGRATIVE MEDICINE, LLC on April 30, 2019. It is a Type-2 NPI, indicating this NPI number is associated with an organization. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 261Q00000X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center. Bear in mind that having a taxonomy code selected doesn't replace any credentialing or validation process that may be required by law.
The NPI profile was previously updated about 4 years ago on Mar 30, 2022. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for ILLUMINATION ROCK INTEGRATIVE MEDICINE, LLC below.
NPI Profile for
ILLUMINATION ROCK INTEGRATIVE MEDICINE, LLC
(more than 7 years ago)
PORTLAND, OR 97206-3913 Phone: (503) 482-7556 Fax: (971) 244-9171
MANAGING MEMBER
Phone: (971) 229-2140
Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.
Identifiers for ILLUMINATION ROCK INTEGRATIVE MEDICINE, LLC
Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.
| Description | Issuer | State | Identifier |
|---|---|---|---|
| OTHER | NPI TYPE 1 | 1932568458 | |
| MEDICAID | OR | 500703138 |
A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.
| Taxonomy Classification / Specialization | State | License |
|---|---|---|
| 261Q00000X - Clinic/Center (Primary) |
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| 225700000X - Massage Therapist |
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| 2081P2900X - Physical Medicine & Rehabilitation / Pain Medicine |
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| 2081N0008X - Physical Medicine & Rehabilitation / Neuromuscular Medicine |
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| 175F00000X - Naturopath |
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| 171100000X - Acupuncturist |
The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.