Individual provider Active NPI

Jan Carlo Zegarra, D.C.

  • Chiropractor
  • Foothill Ranch, CA
National Provider Identifier
1124266135
Registry record updated Apr 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
32913 Issued in CA
Practice address
74 Icon
Foothill Ranch, CA 92610-3000
Phone
(787) 234-8371
Fax
(949) 271-4671
NPI assigned
Jan 29, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 32913 CA Primary

Addresses

Primary practice location

74 Icon
Foothill Ranch, CA 92610-3000

Mailing address

74 Icon
Foothill Ranch, CA 92610-3000
Phone (949) 390-9209

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jzegarra1158656@oc.providencedirect.org

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

Practice roles

OrganizationSpecialtyStatusNew patients
Sportslab Socal Dr. JC Zegarra Chiropractic PC Chiropractor Current Accepting new patients
Triangle Chiropractic PC Chiropractor PastSince Oct 19, 2009 Accepting new patients

Locations

74 Icon
Lake Forest, CA 92610
Phone (949) 238-8069

Interoperability endpoints

  • Direct secure messaging: jzegarra1158656@oc.providencedirect.org

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": "1233187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618876800000",
    "number": "1124266135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "74 ICON",
            "city": "FOOTHILL RANCH",
            "state": "CA",
            "postal_code": "926103000",
            "telephone_number": "949-390-9209",
            "fax_number": "949-271-4671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "74 ICON",
            "city": "FOOTHILL RANCH",
            "state": "CA",
            "postal_code": "926103000",
            "telephone_number": "787-234-8371",
            "fax_number": "949-271-4671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZEGARRA",
        "first_name": "JAN CARLO",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-01-29",
        "last_updated": "2021-04-20",
        "certification_date": "2021-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "32913",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jzegarra1158656@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "600 Newport Center Dr Ste 150",
            "city": "Newport Beach",
            "state": "CA",
            "country_code": "US",
            "postal_code": "926606418",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Foothill Ranch, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2021; 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.