Individual provider Active NPI

Jess M Pontious, D.C.

  • Chiropractor
  • Danville, CA
National Provider Identifier
1073665717
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
680230982 Issued in CA
Practice address
9500 Crow Canyon Rd
Suite C
Danville, CA 94506-1188
Phone
(925) 648-4550
Fax
(925) 648-4553
NPI assigned
Jan 16, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 680230982 CA Primary

Addresses

Primary practice location

9500 Crow Canyon Rd
Suite C
Danville, CA 94506-1188

Mailing address

9500 Crow Canyon Rd
Suite C
Danville, CA 94506-1188
Phone (925) 648-4550

Other identifiers 1

IdentifierTypeStateIssuer
680230928OtherCATAX ID#

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050720001183 CA Practitioner - Chiropractic 0345277307 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College - West, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

9500 Crow Canyon Rd
Suite C
Danville, CA 94506-1100
Phone (925) 648-4550

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
680230982CAMDChiropractor
18921CAMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Pontious Chiropractic Prof. Corp. Chiropractor CurrentSince Sep 24, 2012 Accepting new patients

Locations

9500 Crow Canyon Rd
Ste C
Danville, CA 94506
Phone (925) 648-4550

Organizations & group practices 1

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": "1168905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1073665717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9500 CROW CANYON RD",
            "address_2": "SUITE C",
            "city": "DANVILLE",
            "state": "CA",
            "postal_code": "945061188",
            "telephone_number": "925-648-4550",
            "fax_number": "925-648-4553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9500 CROW CANYON RD",
            "address_2": "SUITE C",
            "city": "DANVILLE",
            "state": "CA",
            "postal_code": "945061188",
            "telephone_number": "925-648-4550",
            "fax_number": "925-648-4553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PONTIOUS",
        "first_name": "JESS",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "680230982",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID#",
            "identifier": "680230928",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Danville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.