Individual provider Active NPI

Jason Lee Loth, D.C.

  • Sports Physician Chiropractor
  • Gilbert, AZ
National Provider Identifier
1063560308
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Physician ChiropractorTaxonomy code 111NS0005X
License
5900 Issued in AZ
Practice address
1425 W Elliot Rd
#203
Gilbert, AZ 85233-5129
Phone
(480) 812-9000
Fax
(480) 812-9040
NPI assigned
Jan 5, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Physician Chiropractor 111NS0005X 5900 AZ Primary

Addresses

Primary practice location

1425 W Elliot Rd
#203
Gilbert, AZ 85233-5129

Mailing address

1425 W Elliot Rd
#203
Gilbert, AZ 85233-5129
Phone (480) 812-9000

Other identifiers 4

IdentifierTypeStateIssuer
1936614OtherAZFIRST HEALTH
623803OtherAZACN
AZ0938770OtherAZBCBS
1Z0112OtherAZHEALTHNET

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050928001504 AZ Practitioner - Chiropractic 7214911650 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pentz Health Services LLCGroup PAC ID 1557392214, 7 clinicians

Practice addresses (Care Compare)

6402 E Superstition Springs Blvd
Suite 123
Mesa, AZ 85206-4391
Phone (480) 833-0302

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2900AZMDGeneral Practice Dentistry
5900AZMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Pentz Health Services LLC Chiropractor CurrentSince Mar 1, 2017 Accepting new patients
Infinite Health & Wellness Centers PLLC Chiropractor PastSince Mar 1, 2017 Accepting new patients

Locations

6402 E Superstition Springs Blvd
Ste 123
Mesa, AZ 85206
Phone (480) 794-1061

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IGHGDD/Endpoint/IGHGDD
  • FHIR API: https://api.platform.athenahealth.com/2509/brand/1/csg/1/fhir/r4

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1167955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1063560308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1425 W ELLIOT RD",
            "address_2": "#203",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852335129",
            "telephone_number": "480-812-9000",
            "fax_number": "480-812-9040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1425 W ELLIOT RD",
            "address_2": "#203",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852335129",
            "telephone_number": "480-812-9000",
            "fax_number": "480-812-9040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOTH",
        "first_name": "JASON",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-05",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "AZ",
            "license": "5900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST HEALTH",
            "identifier": "1936614",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ACN",
            "identifier": "623803",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "AZ0938770",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "1Z0112",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gilbert, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.