Individual provider Active NPI

Jay R. Robbins, D.C.

  • Chiropractor
  • Covina, CA
National Provider Identifier
1205919081
Registry record updated Jan 4, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
20369DC Issued in CA
Practice address
245 W Badillo St Ste E
Covina, CA 91723-1923
Phone
(626) 967-6461
Fax
(626) 332-4264
NPI assigned
Oct 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nutrition Chiropractor 111NN1001X 20369 CA
Chiropractor 111N00000X 20369DC CA Primary

Addresses

Primary practice location

245 W Badillo St Ste E
Covina, CA 91723-1923

Mailing address

245 W Badillo St Ste E
Covina, CA 91723-1923
Phone (626) 967-6461

Other identifiers 1

IdentifierTypeStateIssuer
95-3394768OtherCATAX ID

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031215000996 CA Practitioner - Chiropractic 4587561899 Practice locations: Covina, CA

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Los Angeles College of Chiropractic, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

245 W Badillo St
Suite E
Covina, CA 91723-1923
Phone (626) 967-6461

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
20369DCCAMDChiropractor
20639CAMDNurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483488000000",
    "number": "1205919081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "245 W BADILLO ST STE E",
            "city": "COVINA",
            "state": "CA",
            "postal_code": "917231923",
            "telephone_number": "626-967-6461",
            "fax_number": "626-332-4264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "245 W BADILLO ST STE E",
            "city": "COVINA",
            "state": "CA",
            "postal_code": "917231923",
            "telephone_number": "626-967-6461",
            "fax_number": "626-332-4264"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBBINS",
        "first_name": "JAY",
        "middle_name": "R.",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-23",
        "last_updated": "2017-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NN1001X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Nutrition",
            "state": "CA",
            "license": "20369",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "20369DC",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "95-3394768",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Covina, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.