Individual provider Active NPI

Jakob Taylor, D.C.

  • Chiropractor
  • Chattanooga, TN
National Provider Identifier
1093007007
Registry record updated Jun 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC2339 Issued in TN
Practice address
6102 Shallowford Road
103
Chattanooga, TN 37421
Phone
(423) 475-6464
Fax
(423) 475-6458
NPI assigned
May 9, 2011
Last updated
Jun 4, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2301009851 MI
Chiropractor 111N00000X DC2339 TN Primary

Addresses

Primary practice location

6102 Shallowford Road
103
Chattanooga, TN 37421

Mailing address

6102 Shallowford Road
103
Chattanooga, TN 37421
Phone (423) 475-6464

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120717000299 TN Practitioner - Chiropractic 6709042963 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - West Sunnyvale, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
True Wellness Medical LLCGroup PAC ID 8729481262, 4 clinicians

Practice addresses (Care Compare)

6102 Shallowford Rd
Suite 103
Chattanooga, TN 37421-1684
Phone (423) 661-3428

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2301009851MIMDChiropractor
DC2339TNMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
True Wellness Medical LLC. CurrentSince Jan 1, 2012 Accepting new patients
Southern Life Healthcare PLLC CurrentSince Oct 1, 2016 Accepting new patients
Healthsource of Cleveland PLLC Chiropractor PastSince Feb 1, 2013 Accepting new patients

Locations

6102 Shallowford Rd
Ste 103
Chattanooga, TN 37421
Phone (423) 475-6438

6102 Shallowford Rd
Ste 104
Chattanooga, TN 37421
Phone (423) 206-9214

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": "1304899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717459200000",
    "number": "1093007007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6102 SHALLOWFORD ROAD",
            "address_2": "103",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "37421",
            "telephone_number": "423-475-6464",
            "fax_number": "423-475-6458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6102 SHALLOWFORD ROAD",
            "address_2": "103",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "37421",
            "telephone_number": "423-475-6464",
            "fax_number": "423-475-6458"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "JAKOB",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-05-09",
        "last_updated": "2024-06-04",
        "certification_date": "2024-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301009851",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TN",
            "license": "DC2339",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chattanooga, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2024; 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.