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KELSALL CHIROPRACTIC CLINIC PC
NPI 1063674679
Chiropractor - Sports Physician in Portland, OR

Active since June 26, 2008
1615 NW 23RD AVE, SUITE 2, PORTLAND, OR 97210(503) 223-8719(503) 223-3237 Get Directions Write a Review

NPPES record last updated: June 26, 2008. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Kelsall Chiropractic Clinic Pc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KELSALL CHIROPRACTIC CLINIC PC (NPI 1063674679) is a healthcare organization registered as a sports physician in Portland, Oregon and active in the NPI registry since June 2008. The organization lists Amy Burgess, Office Manager, as its authorized official.

NPPES Registry Identity

NPI1063674679
Entity TypeOrganization
Primary Taxonomy111NS0005X
Legal Business NameKELSALL CHIROPRACTIC CLINIC PC
Location Address1615 NW 23RD AVE, SUITE 2Portland, OR 97210-2563
Mailing Address1615 Nw 23rd Ave, Suite 2Portland, OR 97210-2563 · (503) 223-8719 · Fax (503) 223-3237
Phone(503) 223-8719
Fax(503) 223-3237
Organization SubpartNo
Authorized OfficialAmy BurgessOffice Manager · (503) 223-8719
Enumeration DateJune 26, 2008
✔ NPI 1063674679 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyChiropractor · Sports PhysicianChiropractic Providers
Taxonomy Code111NS0005X
License✔ Licensed in OR · 2997
Definition
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.
1615 NW 23RD AVE, Portland, OR 97210
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Other Identifiers 3

Medicare UPINU64819OR
OtherR100924Medicare Provider Id
Medicare PIN134346OR

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Moda Health Plan, Inc..Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kelsall Chiropractic Clinic Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

2

Medicare enrollment records show 2 clinicians reassign Medicare billing to Kelsall Chiropractic Clinic PC, which bills Medicare for the services they deliver. Of these, 2 practice at this address. They are listed nearest first.

Clinicians, nearest first (2)

Shelby Tweto, DC
Chiropractic
NPI 1790739043
1615 NW 23RD AVE STE 2
Portland, OR 97210
(503) 223-8719
✔ PECOSSame address
Karen Kelsall, D.C.
Chiropractic
NPI 1801844568
1615 NW 23RD AVE SUITE 2
Portland, OR 97210
(503) 223-8719
Same address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kelsall Chiropractic Clinic PC's NPI number?

The NPI number for Kelsall Chiropractic Clinic PC is 1063674679. It was assigned to this organization in the NPPES registry on June 26, 2008.

Where is Kelsall Chiropractic Clinic PC located?

Kelsall Chiropractic Clinic PC is located at 1615 NW 23rd Ave Suite 2, Portland, OR 97210. The listed phone number is (503) 223-8719.

What is Kelsall Chiropractic Clinic PC's specialty?

The primary specialty registered for this NPI is Chiropractor, specializing in Sports Physician, with taxonomy code 111NS0005X.

Is Kelsall Chiropractic Clinic PC enrolled in Medicare?

Yes. Kelsall Chiropractic Clinic PC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Kelsall Chiropractic Clinic PC?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians, all in Chiropractic, reassign their Medicare billing to Kelsall Chiropractic Clinic PC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 2 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Kelsall Chiropractic Clinic PC accept?

Health plans from Moda Health Plan, Inc. list Kelsall Chiropractic Clinic PC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Kelsall Chiropractic Clinic PC was last updated on June 26, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.