Individual provider Active NPI

Jennifer Pishotta, DC

  • Chiropractor
  • Belleview, FL
National Provider Identifier
1134633621
Registry record updated Jan 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038013152 Issued in IL
Practice address
5608 SE 113TH St Ste a
Belleview, FL 34420-4069
Phone
(352) 245-8955
NPI assigned
Nov 21, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038013152 IL Primary

Addresses

Primary practice location

5608 SE 113TH St Ste a
Belleview, FL 34420-4069

Mailing address

14 Miller Rd
Lake in the Hills, IL 60156-1008
Phone (224) 678-7334

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
038013152ILMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
TLC Chiropractic, SC Chiropractor CurrentSince Mar 22, 2020 Accepting new patients
McKenney Chiropractic Center PA Chiropractor PastSince Feb 8, 2023 Accepting new patients

Locations

14 Miller Rd
Lake in the Hills, IL 60156
Phone (224) 678-7334

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": "1511222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675036800000",
    "number": "1134633621",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 MILLER RD",
            "city": "LAKE IN THE HILLS",
            "state": "IL",
            "postal_code": "601561008",
            "telephone_number": "224-678-7334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5608 SE 113TH ST STE A",
            "city": "BELLEVIEW",
            "state": "FL",
            "postal_code": "344204069",
            "telephone_number": "352-245-8955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PISHOTTA",
        "first_name": "JENNIFER",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-21",
        "last_updated": "2023-01-30",
        "certification_date": "2023-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038013152",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Belleview, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2023; 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.