Jet Performance Chiropractic, PA – Chiropractor

Key facts

NPI: 1154561124
Entity type: Organization (NPI type 2)
Primary specialty: Chiropractor 111N00000X
License: 01-05209 (KS)
Legal business name: JET PERFORMANCE CHIROPRACTIC, PA
Practice address: 12402 W 62ND Ter
Shawnee, KS 66216-1810
Phone: (913) 766-9266
Fax: (913) 766-9265
NPI assigned: Mar 3, 2009
Organization subpart: No

Authorized official

Name: Dr. Joel Erron Terry, D.C. NPI 1790934065
Title: Owner
Phone: (913) 766-9266

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

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Joel Erron Terry, D.C. Chiropractor · Platte City, MO · NPI 1790934065

NPD (past) Authorized official CHIROPRACTOR

National Provider Directory

Locations

12402 W 62nd Ter
Shawnee, KS 66216
Phone (913) 766-9266

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Chiropractor Group: 193400000X SINGLE SPECIALTY GROUP	111N00000X	01-05209	KS	Yes

Addresses

Primary practice location

12402 W 62ND Ter
Shawnee, KS 66216-1810

Mailing address

12402 W 62ND Ter
Shawnee, KS 66216-1810
Phone (913) 766-9266

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Nov 3, 2009.

{
    "created_epoch": "1236038400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1257206400000",
    "number": "1154561124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12402 W 62ND TER",
            "city": "SHAWNEE",
            "state": "KS",
            "postal_code": "662161810",
            "telephone_number": "913-766-9266",
            "fax_number": "913-766-9265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12402 W 62ND TER",
            "city": "SHAWNEE",
            "state": "KS",
            "postal_code": "662161810",
            "telephone_number": "913-766-9266",
            "fax_number": "913-766-9265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JET PERFORMANCE CHIROPRACTIC, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-03",
        "last_updated": "2009-11-03",
        "status": "A",
        "authorized_official_last_name": "TERRY",
        "authorized_official_first_name": "JOEL",
        "authorized_official_middle_name": "ERRON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "913-766-9266",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "KS",
            "license": "01-05209",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shawnee, KS

All providers in Shawnee, KS · Chiropractor in Kansas

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 3, 2009. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.