Individual provider Active NPI

Jonthan Kyle Eaton, D.C.

  • Chiropractor
  • Jasper, AL
National Provider Identifier
1104983832
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2011 Issued in AL
Practice address
2753 Highway 195
Jasper, AL 35503-6241
Phone
(205) 221-2442
Fax
(205) 221-2437
NPI assigned
Jan 2, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2011 AL Primary

Addresses

Primary practice location

2753 Highway 195
Jasper, AL 35503-6241

Mailing address

2753 Highway 195
Jasper, AL 35503-6241
Phone (205) 221-2442

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050103000770 AL Practitioner - Chiropractic 0648238998 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2753 Hwy 195
Jasper, AL 35503-6241
Phone (205) 221-2442

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2011ALMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
J. Kyle Eaton, D.C., P.C. Chiropractor CurrentSince Nov 30, 2004 Accepting new patients

Locations

2753 Highway 195
Jasper, AL 35503
Phone (205) 221-2442

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": "1167696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104983832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2753 HIGHWAY 195",
            "city": "JASPER",
            "state": "AL",
            "postal_code": "355036241",
            "telephone_number": "205-221-2442",
            "fax_number": "205-221-2437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2753 HIGHWAY 195",
            "city": "JASPER",
            "state": "AL",
            "postal_code": "355036241",
            "telephone_number": "205-221-2442",
            "fax_number": "205-221-2437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EATON",
        "first_name": "JONTHAN",
        "middle_name": "KYLE",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AL",
            "license": "2011",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jasper, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.