Canby Spine & Sport – Chiropractor, NPI 1043491178

Canby Spine & Sport is a healthcare provider. based in Canby, Oregon. specializing in Chiropractor. The organization holds a License No. 273072 (OR). The NPI Number for Canby Spine & Sport is 1043491178

Main info

Organization
Name
Canby Spine & Sport
NPI
1043491178
Phone
(503) 263-3033
Address
130 SW 2ND AVE STE 101
Authorized Official
DR. MICHAEL JAY VISSERS PRESIDENT D.C.
Enumeration Date
16 November 2007
Last Update Date
1 June 2022
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience60
Completeness80
Years active:18State licenses:1Digital endpointsUpdated within 12 months

Provider Addresses for Canby Spine & Sport

  • 101, Southwest 2nd Avenue, Canby, Clackamas County, Oregon, 97013, United States

    CANBY, OR 970134156

    Phone: (503) 263-3033

    Fax: (503) 263-3023

    Type: Mailing

  • 317 N Molalla Ave

    Molalla, OR 970388840

    Phone: (503) 829-6176

    Fax: (503) 829-6178

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2010-12-08

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Past revalidation due date

Earliest CMS due date was 2023-12-31 (891 days ago).

Enrollment records

1

Earliest due date

2023-12-31

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20101208001131OClinic/Group PracticeOR2023-12-31

What to do next

  • Verify current status on the CMS Revalidation Lookup Tool immediately.
  • Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
  • Overdue revalidation can lead to deactivation of Medicare billing privileges.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 97013)

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Reviews

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Frequently asked questions

How do payers reference Canby Spine & Sport?
For Canby Spine & Sport, use NPI 1043491178 as the unique 10-digit identifier.
Is Canby Spine & Sport shown as active in public data?
Registry records indicate Canby Spine & Sport maintains an active NPI.
How would a patient describe Canby Spine & Sport's focus?
For Canby Spine & Sport, the primary taxonomy reads as Chiropractor. Clinical services aligned with this taxonomy classification.
What practice footprint exists for Canby Spine & Sport?
Travel planning: use Canby, Oregon as the reference point for Canby Spine & Sport, then confirm.
Does Canby Spine & Sport accept insurance?
Insurance participation is not part of the core NPI extract — call the plan or office to confirm.

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