Individual provider Active NPI

Jared Thomas Wooley, D.C.

  • Chiropractor
  • Missouri City, TX
National Provider Identifier
1093139370
Registry record updated Feb 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
12522 Issued in TX
Practice address
4642 Riverstone Blvd
Missouri City, TX 77459-6141
Phone
(281) 499-4810
Fax
(281) 499-3005
NPI assigned
Feb 7, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 12522 TX Primary

Addresses

Primary practice location

4642 Riverstone Blvd
Missouri City, TX 77459-6141

Mailing address

4642 Riverstone Blvd
Missouri City, TX 77459-6141
Phone (281) 499-4810

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150122000261 LA Practitioner - Chiropractic 0749412229 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

8786 Goodwood Blvd
Suite 101
Baton Rouge, LA 70806-7917
Phone (225) 924-5002

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1718LAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Acadian Chiropractic & Wellness LLC Chiropractor CurrentSince Jul 1, 2021 Accepting new patients
All American Nola, LLC Chiropractor Past Accepting new patients

Locations

8786 Goodwood Blvd
Ste 101
Baton Rouge, LA 70806
Phone (225) 924-5002

Networks

  • LA PPO C-SNP

Organizations & group practices 2

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": "1391731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391731200000",
    "number": "1093139370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4642 RIVERSTONE BLVD",
            "city": "MISSOURI CITY",
            "state": "TX",
            "postal_code": "774596141",
            "telephone_number": "281-499-4810",
            "fax_number": "281-499-3005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4642 RIVERSTONE BLVD",
            "city": "MISSOURI CITY",
            "state": "TX",
            "postal_code": "774596141",
            "telephone_number": "281-499-4810",
            "fax_number": "281-499-3005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOOLEY",
        "first_name": "JARED",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-02-07",
        "last_updated": "2014-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "12522",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Missouri City, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2014; 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.