Active NPI
Jay J Meverden, D.C.
- Sports Physician Chiropractor
- Wausau, WI
National Provider Identifier
1205927951
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Sports Physician Chiropractor
- License
- 1673
- Practice address
- 2600 Stewart Ave
Suite 154
Wausau, WI 54401-4148 - Phone
- (715) 848-4088
- Fax
- (715) 842-2496
- NPI assigned
- Sep 27, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Sports Physician Chiropractor | 111NS0005X | 1673 | WI | Primary |
Addresses
Primary practice location
2600 Stewart Ave
Suite 154
Wausau, WI 54401-4148
Mailing address
8707 Townline Rd
Wausau, WI 54403-8634
Phone (715) 848-1772
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 38770900 | Medicaid | WI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1673 | WI | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jay J Meverden | Sports Physician | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159315200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1205927951",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8707 TOWNLINE RD",
"city": "WAUSAU",
"state": "WI",
"postal_code": "544038634",
"telephone_number": "715-848-1772"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2600 STEWART AVE",
"address_2": "SUITE 154",
"city": "WAUSAU",
"state": "WI",
"postal_code": "544014148",
"telephone_number": "715-848-4088",
"fax_number": "715-842-2496"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEVERDEN",
"first_name": "JAY",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-09-27",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111NS0005X",
"taxonomy_group": "",
"desc": "Chiropractor, Sports Physician",
"state": "WI",
"license": "1673",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "38770900",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Wausau, WI
Sources for this page
- 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.