Individual provider Active NPI

Jamie Paquette, DC

  • Chiropractor
  • Williamsburg, VA
National Provider Identifier
1114539038
Registry record updated Aug 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
0104557671 Issued in VA
Practice address
4808 Courthouse St Ste 202
Williamsburg, VA 23188-2684
Phone
(757) 345-6562
Fax
(757) 345-6516
NPI assigned
Aug 21, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 0104557671 VA Primary

Addresses

Primary practice location

4808 Courthouse St Ste 202
Williamsburg, VA 23188-2684

Mailing address

4808 Courthouse St Ste 202
Williamsburg, VA 23188-2684
Phone (757) 345-6562

Other identifiers 1

IdentifierTypeStateIssuer
0104557671OtherVAHEALTH PROFESSIONS LICENSE

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
0104557671VAMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1597968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597968000000",
    "number": "1114539038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4808 COURTHOUSE ST STE 202",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "231882684",
            "telephone_number": "757-345-6562",
            "fax_number": "757-345-6516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4808 COURTHOUSE ST STE 202",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "231882684",
            "telephone_number": "757-345-6562",
            "fax_number": "757-345-6516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAQUETTE",
        "first_name": "JAMIE",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-08-21",
        "last_updated": "2020-08-21",
        "certification_date": "2020-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "VA",
            "license": "0104557671",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PROFESSIONS LICENSE",
            "identifier": "0104557671",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2020; 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.