Jack Thomas Li, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

DC 31142 Issued in CA

Practice address

12340 Santa Monica Blvd
Suite 130
Los Angeles, CA 90025-2500

Phone

(310) 207-1007

NPI assigned

Feb 23, 2009

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Specialty

Chiropractic

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Jack Li, D.C., a Chiropractic Corporation

  • Chiropractor
  • Los Angeles, CA
  • NPI 1639715352
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1235347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1235347200000",
    "number": "1043450653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12340 SANTA MONICA BLVD",
            "address_2": "SUITE 130",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900252500",
            "telephone_number": "310-207-1007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12340 SANTA MONICA BLVD",
            "address_2": "SUITE 130",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900252500",
            "telephone_number": "310-207-1007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LI",
        "first_name": "JACK",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-02-23",
        "last_updated": "2009-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC 31142",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Haoran Li
• Hoi Li
• Hongmei Jane Li, O.M.D.
• Ien Li
• Ivy Oi-Wan Li, D.D.S.
• Janice Wenjuan Li, PHARMACIST
• Jennifer Li, MD
• Jennifer Meng Li
• Jia Xin Li
• Jianfeng Li

• Chiropractor in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Chiropractor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2009; 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.