Organization Active NPI

Pontious Chiropractic Prof. Corp.

  • Chiropractor
  • Danville, CA
National Provider Identifier
1184987729
Registry record updated Feb 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
18921 Issued in CA
Legal business name
PONTIOUS CHIROPRACTIC PROF. CORP.
Practice address
9500 Crow Canyon Rd
Suite C
Danville, CA 94506-1188
Phone
(925) 648-4550
Fax
(925) 648-4553
NPI assigned
Jun 19, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2014

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

Authorized official

Name
Dr. Jess Matthew Pontious, D.C.NPI 1073665717
Title
Ceo
Phone
(925) 648-4550

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 18921 CA Primary

Addresses

Primary practice location

9500 Crow Canyon Rd
Suite C
Danville, CA 94506-1188

Mailing address

9500 Crow Canyon Rd
Suite C
Danville, CA 94506-1188
Phone (925) 648-4550

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120928000511 CA Part B Supplier - Clinic/Group Practice 3375792799 Receives reassigned benefits from 1 practitioner
Practice locations: Danville, CA

National Provider Directory

National Provider Directory

Locations

9500 Crow Canyon Rd
Ste C
Danville, CA 94506
Phone (925) 648-4550

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1340064000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1392681600000",
    "number": "1184987729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9500 CROW CANYON RD",
            "address_2": "SUITE C",
            "city": "DANVILLE",
            "state": "CA",
            "postal_code": "945061188",
            "telephone_number": "925-648-4550",
            "fax_number": "925-648-4553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9500 CROW CANYON RD",
            "address_2": "SUITE C",
            "city": "DANVILLE",
            "state": "CA",
            "postal_code": "945061188",
            "telephone_number": "925-648-4550",
            "fax_number": "925-648-4553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PONTIOUS CHIROPRACTIC PROF. CORP.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-19",
        "last_updated": "2014-02-18",
        "status": "A",
        "authorized_official_last_name": "PONTIOUS",
        "authorized_official_first_name": "JESS",
        "authorized_official_middle_name": "MATTHEW",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "925-648-4550",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "18921",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Danville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.