NPIMap

Organization Active NPI

Dr. Jonathan E Jack DC PLLC

  • Chiropractor
  • Creekside, PA
National Provider Identifier
1194017806
Registry record updated May 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC 005990L Issued in PA
Legal business name
DR. JONATHAN E JACK DC PLLC
Practice address
2118 Kettering Rd
Creekside, PA 15732-9237
Phone
(724) 397-9531
NPI assigned
May 12, 2011
Last updated
May 12, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 12, 2011

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

Authorized official

Name
Dr. Jonathan Elliott Jack, DCNPI 1730114174
Title
Doctor/Owner
Phone
(724) 397-9531

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC 005990L PA Primary

Addresses

Primary practice location

2118 Kettering Rd
Creekside, PA 15732-9237

Mailing address

2118 Kettering Rd
Creekside, PA 15732-9237
Phone (724) 397-9531

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1305158400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1305158400000",
    "number": "1194017806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2118 KETTERING RD",
            "city": "CREEKSIDE",
            "state": "PA",
            "postal_code": "157329237",
            "telephone_number": "724-397-9531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2118 KETTERING RD",
            "city": "CREEKSIDE",
            "state": "PA",
            "postal_code": "157329237",
            "telephone_number": "724-397-9531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. JONATHAN E JACK DC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-12",
        "last_updated": "2011-05-12",
        "status": "A",
        "authorized_official_last_name": "JACK",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_middle_name": "ELLIOTT",
        "authorized_official_title_or_position": "DOCTOR/OWNER",
        "authorized_official_telephone_number": "724-397-9531",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "PA",
            "license": "DC 005990L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Creekside, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2011; 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.