Individual provider Active NPI

Jason Michael Stephens, DC

  • Chiropractor
  • Johnstown, PA
National Provider Identifier
1124189170
Registry record updated Aug 16, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC009706 Issued in PA
Practice address
401 Theatre Dr
Johnstown, PA 15904-2838
Phone
(814) 269-3116
Fax
(814) 266-8471
NPI assigned
Dec 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 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 DC009706 PA Primary

Addresses

Primary practice location

401 Theatre Dr
Johnstown, PA 15904-2838

Mailing address

48 Aspen CT
Cresson, PA 16630-1850
Phone (814) 937-2078

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070321000674 PA Practitioner - Chiropractic 2961505441 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
New York Chiropractic College, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Live Well Chiropractic PCGroup PAC ID 1658465349, 4 clinicians

Practice addresses (Care Compare)

1634 Quaker Valley Rd
New Paris, PA 15554-8509
Phone (814) 624-0606

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Live Well Chiropractic, P.C. Chiropractor CurrentSince Oct 1, 2012 Accepting new patients
Wise Chiropractic & Rehabilitation Center Inc Chiropractor Past Accepting new patients

Locations

1634 Quaker Valley Rd
#2
New Paris, PA 15554
Phone (814) 624-0606

1634 Quaker Valley Rd
New Paris, PA 15554
Phone (814) 285-6412

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": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1187222400000",
    "number": "1124189170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "48 ASPEN CT",
            "city": "CRESSON",
            "state": "PA",
            "postal_code": "166301850",
            "telephone_number": "814-937-2078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 THEATRE DR",
            "city": "JOHNSTOWN",
            "state": "PA",
            "postal_code": "159042838",
            "telephone_number": "814-269-3116",
            "fax_number": "814-266-8471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEPHENS",
        "first_name": "JASON",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-13",
        "last_updated": "2007-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "PA",
            "license": "DC009706",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnstown, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 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.