Jesse Porter Shultz, D.C.
Individual provider Active NPI Chiropractor · Akron, IN
NPI 1194153437 · NPPES record last updated Oct 24, 2013
Key facts
- NPI
- 1194153437
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 08002739B (IN)
- Practice address
- 12106 E State Road 114
Akron, IN 46910-9416 - Phone
- (574) 893-4131
- NPI assigned
- Oct 24, 2013
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20140228001954 | IN | Practitioner - Chiropractic | 7416187901 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 08002739B | IN | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Akron Family Chiropractic, LLC | Chiropractor | Current |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 08002739B | IN | Yes |
Addresses
Primary practice location
12106 E State Road 114
Akron, IN 46910-9416
Mailing address
12106 E State Road 114
PO Box 206
Akron, IN 46910-9416
Other providers in Akron, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 24, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.