Jeffry Vincent Popham, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

DC4366 Issued in TX

Practice address

929 Loop 332
Liberty Hill, TX 78642-0037

Phone

(512) 778-5500

Fax

(512) 778-5500

NPI assigned

Jan 18, 2007

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Specialty

Chiropractic

Education

Other, 1986

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1238716800000",
    "number": "1083766919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 37",
            "address_2": "929 LOOP 332",
            "city": "LIBERTY HILL",
            "state": "TX",
            "postal_code": "786420037",
            "telephone_number": "512-778-5500",
            "fax_number": "512-778-5500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "929 LOOP 332",
            "city": "LIBERTY HILL",
            "state": "TX",
            "postal_code": "786420037",
            "telephone_number": "512-778-5500",
            "fax_number": "512-778-5500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POPHAM",
        "first_name": "JEFFRY",
        "middle_name": "VINCENT",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-18",
        "last_updated": "2009-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "DC4366",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD #",
            "identifier": "601658",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Liberty Hill, TX
• Providers in Liberty Hill, TX by specialty
• Chiropractor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 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.