Individual provider Active NPI

Jason Thomas Job, D.C.

  • Chiropractor
  • Deland, FL
National Provider Identifier
1104367457
Registry record updated Apr 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH12154 Issued in FL
Practice address
905 N Stone St
Deland, FL 32720-2521
Phone
(386) 337-3884
NPI assigned
Mar 19, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Chiropractor 111N00000X CH12154 FL Primary

Addresses

Primary practice location

905 N Stone St
Deland, FL 32720-2521

Mailing address

905 N Stone St
Deland, FL 32720-2521
Phone (386) 337-3884

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170523000093 FL Practitioner - Chiropractic 3375810344 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jeremy M Gordon DC PAGroup PAC ID 7911927041, 4 clinicians

Practice addresses (Care Compare)

905 N Stone St
Deland, FL 32720-2521
Phone (386) 734-9995

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH12154FLMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Jeremy M Gordon DC PA CurrentSince May 8, 2017 Accepting new patients

Locations

905 N Stone St
Deland, FL 32720
Phone (386) 341-6948

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": "1489881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491436800000",
    "number": "1104367457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "905 N STONE ST",
            "city": "DELAND",
            "state": "FL",
            "postal_code": "327202521",
            "telephone_number": "386-337-3884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "905 N STONE ST",
            "city": "DELAND",
            "state": "FL",
            "postal_code": "327202521",
            "telephone_number": "386-337-3884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOB",
        "first_name": "JASON",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-19",
        "last_updated": "2017-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH12154",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Deland, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2017; 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.