Jacob Matthew Doudna
Individual provider Active NPI Chiropractor · Flushing, OH
NPI 1205512464 · NPPES record last updated Jun 23, 2023
Key facts
- NPI
- 1205512464
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- DC-05274 (OH)
- Practice address
- 432 High St
Flushing, OH 43977-9733 - Phone
- (740) 968-3610
- Fax
- (740) 968-3502
- NPI assigned
- Jun 23, 2023
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Chiropractic
- Education
- Palmer College Chiropractic - Davenport, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Shane D. Bashline, Inc.
Practice addresses (Care Compare)
432 E High St
Flushing, OH 43977-9733
Phone (740) 968-3610
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240206001043 | OH | Practitioner - Chiropractic | 7214370303 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DC-05274 | OH | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Shane D. Bashline, Inc. | Chiropractor | Current |
Accepting new patients |
Locations
432 High St
Flushing, OH 43977
Phone (740) 968-3610
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | DC-05274 | OH | Yes |
Addresses
Primary practice location
432 High St
Flushing, OH 43977-9733
Mailing address
432 High St
Flushing, OH 43977-9733
Phone (740) 968-3610
Other providers in Flushing, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 23, 2023. 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.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.