Individual provider Active NPI

Jerry Levi Jr., DC

  • Chiropractor
  • Colorado Springs, CO
National Provider Identifier
1033203138
Registry record updated May 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5452 Issued in CO
Practice address
1465 Kelly Johnson Blvd Ste 100
Colorado Springs, CO 80920-3945
Phone
(719) 593-1227
NPI assigned
Oct 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 5452 CO Primary

Addresses

Primary practice location

1465 Kelly Johnson Blvd Ste 100
Colorado Springs, CO 80920-3945

Mailing address

1465 Kelly Johnson Blvd Ste 100
Colorado Springs, CO 80920-3945
Phone (719) 593-1227

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061215000145 CO Practitioner - Chiropractic 1759380975 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Colorado Health and Wellness, Inc.Group PAC ID 3779538400, 5 clinicians

Practice addresses (Care Compare)

1231 Lake Plaza Dr
Colorado Springs, CO 80906-3571
Phone (719) 576-2225

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5452COMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Colorado Health and Wellness, Inc. Chiropractor CurrentSince Jan 3, 2018 Accepting new patients
Salsman Chiropractic Health Center Chiropractor PastSince Jan 3, 2018 Accepting new patients
Summit Chiropractic PC Chiropractor Past Accepting new patients

Locations

1231 Lake Plaza Dr
Ste B
Colorado Springs, CO 80906

1231 Lake Plaza Dr
Colorado Springs, CO 80906
Phone (719) 576-2225

Networks

  • CO HMO
  • CO HMO C-SNP
  • CO HMO D-SNP
  • devoted network organization-a4751131-f16f-4e82-8f2b-b08e66379a7a

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335916800000",
    "number": "1033203138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1465 KELLY JOHNSON BLVD STE 100",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809203945",
            "telephone_number": "719-593-1227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1465 KELLY JOHNSON BLVD STE 100",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809203945",
            "telephone_number": "719-593-1227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEVI",
        "first_name": "JERRY",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2012-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CO",
            "license": "5452",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.