Organization Active NPI

Jessica L Tobin

Doing business as Tobin Chiropractic

  • Chiropractor
  • Powell, WY
National Provider Identifier
1114116761
Registry record updated Feb 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
657 Issued in WY
Legal business name
JESSICA L TOBIN
Doing business as
Tobin Chiropractic
Practice address
403 E 2ND St
Powell, WY 82435-1927
Phone
(307) 754-3436
Fax
(307) 754-7938
NPI assigned
Oct 19, 2007
Reactivated
May 13, 2008
Last updated
Feb 19, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2016

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

Authorized official

Name
Dr. Jessica L Tobin, DCNPI 1942368188
Title
Office Manager Owner
Phone
(307) 754-3436

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 657 WY Primary

Addresses

Primary practice location

403 E 2ND St
Powell, WY 82435-1927

Mailing address

403 E 2ND St
Powell, WY 82435-1927
Phone (307) 754-3436

Other names 1

  • Tobin Chiropractic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060327000126 WY Part B Supplier - Clinic/Group Practice 5698783157 Receives reassigned benefits from 1 practitioner
Practice locations: Powell, WY

National Provider Directory

National Provider Directory

Locations

403 E 2nd St
Powell, WY 82435
Phone (307) 754-3436

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1192752000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1455840000000",
    "number": "1114116761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "403 E 2ND ST",
            "city": "POWELL",
            "state": "WY",
            "postal_code": "824351927",
            "telephone_number": "307-754-3436",
            "fax_number": "307-754-7938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "403 E 2ND ST",
            "city": "POWELL",
            "state": "WY",
            "postal_code": "824351927",
            "telephone_number": "307-754-3436",
            "fax_number": "307-754-7938"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JESSICA L TOBIN",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-19",
        "last_updated": "2016-02-19",
        "deactivation_date": "2008-01-22",
        "reactivation_date": "2008-05-13",
        "status": "A",
        "authorized_official_last_name": "TOBIN",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OFFICE MANAGER OWNER",
        "authorized_official_telephone_number": "307-754-3436",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "WY",
            "license": "657",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tobin Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Powell, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.