Jay Allen Ebel, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

3038 Issued in MN

Practice address

2330 Sioux Trail N.W.
Prior Lake, MN 55372

Phone

(952) 233-4271

Fax

(952) 233-4224

NPI assigned

Jul 5, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Shakopee Mdewakanton Sioux Community

  • Family Medicine Physician
  • Prior Lake, MN
  • NPI 1013933381

  Chiropractor

  NPD (past)
• Active Family Chiropractic P.C.

  • Chiropractor
  • Hankinson, ND
  • NPI 1437361599
  NPD (past)

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

{
    "created_epoch": "1120521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1194722207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "915 - 7TH STREET, #15",
            "city": "JORDAN",
            "state": "MN",
            "postal_code": "55352",
            "telephone_number": "952-378-1030",
            "fax_number": "952-378-1030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2330 SIOUX TRAIL N.W.",
            "city": "PRIOR LAKE",
            "state": "MN",
            "postal_code": "55372",
            "telephone_number": "952-233-4271",
            "fax_number": "952-233-4224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EBEL",
        "first_name": "JAY",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "ND",
            "license": "538",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "3038",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "3C096CB",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "17722",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "3C095HA",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "11445",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Prior Lake, MN
• Providers in Prior Lake, MN by specialty
• Chiropractor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.