Individual provider Active NPI

Jared Matson Piper, DVM

  • Veterinarian
  • O'Fallon, IL
National Provider Identifier
1053664045
Registry record updated Oct 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
VeterinarianTaxonomy code 174M00000X
License
090010998 Issued in IL
Practice address
816 Bridgeway Drive
O'Fallon, IL 62269
Phone
(732) 279-4313
NPI assigned
Oct 16, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 16, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Veterinarian 174M00000X 090010998 IL Primary

Addresses

Primary practice location

816 Bridgeway Drive
O'Fallon, IL 62269

Mailing address

816 Bridgeway Drive
O'Fallon, IL 62269
Phone (732) 279-4313

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

LicenseStateTypeSpecialty
090010998ILMDVeterinarian

NPI Registry JSON

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

{
    "created_epoch": "1350345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350345600000",
    "number": "1053664045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "816 BRIDGEWAY DRIVE",
            "city": "O'FALLON",
            "state": "IL",
            "postal_code": "62269",
            "telephone_number": "732-279-4313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "816 BRIDGEWAY DRIVE",
            "city": "O'FALLON",
            "state": "IL",
            "postal_code": "62269",
            "telephone_number": "732-279-4313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIPER",
        "first_name": "JARED",
        "middle_name": "MATSON",
        "name_prefix": "Dr.",
        "credential": "DVM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-10-16",
        "last_updated": "2012-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174M00000X",
            "taxonomy_group": "",
            "desc": "Veterinarian",
            "state": "IL",
            "license": "090010998",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in O'Fallon, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.