Individual provider Active NPI

William Jerrott Hanlan, D.C.

  • Chiropractor
  • Yreka, CA
National Provider Identifier
1104007509
Registry record updated Jul 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
29668 Issued in CA
Practice address
700 S Main St Ste 2
Yreka, CA 96097-3354
Phone
(530) 340-2399
Fax
(530) 331-0038
NPI assigned
Nov 14, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 26, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Chiropractor 111NR0400X 273531 OR
Chiropractor 111N00000X 29668 CA Primary

Addresses

Primary practice location

700 S Main St Ste 2
Yreka, CA 96097-3354

Mailing address

700 S Main St Ste 2
Yreka, CA 96097-3354
Phone (530) 340-2399

Other identifiers 1

IdentifierTypeStateIssuer
500729537MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
29668CAMDClinical Psychologist
273531ORMDRehabilitation Chiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Yreka Chiropractic Dr J C Morris Inc Current Accepting new patients
Towne Chiropractic Clinic P.C. Chiropractor PastSince Jul 24, 2017 Accepting new patients

Locations

700 S Main St
Ste 2
Yreka, CA 96097
Phone (530) 340-2399

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": "1194998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721952000000",
    "number": "1104007509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 S MAIN ST STE 2",
            "city": "YREKA",
            "state": "CA",
            "postal_code": "960973354",
            "telephone_number": "530-340-2399",
            "fax_number": "530-331-0038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 S MAIN ST STE 2",
            "city": "YREKA",
            "state": "CA",
            "postal_code": "960973354",
            "telephone_number": "530-340-2399",
            "fax_number": "530-331-0038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANLAN",
        "first_name": "WILLIAM",
        "middle_name": "JERROTT",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-11-14",
        "last_updated": "2024-07-26",
        "certification_date": "2024-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Rehabilitation",
            "state": "OR",
            "license": "273531",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "29668",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500729537",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Yreka, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.