Active NPI
Blake Terry, DC
- Chiropractor
- Simi Valley, CA
National Provider Identifier
1043071012
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 35196
- Practice address
- 4352 Cochran St
Simi Valley, CA 93063-2352 - Phone
- (805) 208-7113
- NPI assigned
- Jan 17, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 35196 | CA | Primary |
Addresses
Primary practice location
4352 Cochran St
Simi Valley, CA 93063-2352
Mailing address
4352 Cochran St
Simi Valley, CA 93063-2352
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35196 | CA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1705449600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1705449600000",
"number": "1043071012",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4352 COCHRAN ST",
"city": "SIMI VALLEY",
"state": "CA",
"postal_code": "930632352"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4352 COCHRAN ST",
"city": "SIMI VALLEY",
"state": "CA",
"postal_code": "930632352",
"telephone_number": "805-208-7113"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TERRY",
"first_name": "BLAKE",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-01-17",
"last_updated": "2024-01-17",
"certification_date": "2024-01-17",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "CA",
"license": "35196",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Simi Valley, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.