Individual provider Active NPI

Jeffrey L Bender, D.C.

  • Chiropractor
  • Los Lunas, NM
National Provider Identifier
1215031257
Registry record updated Aug 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1247 Issued in NM
Practice address
209 Highway 314 NW
Los Lunas, NM 87031-6697
Phone
(505) 865-7610
Fax
(505) 865-8673
NPI assigned
Sep 11, 2006
Last updated
Aug 15, 2014By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 15, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1247 NM Primary

Addresses

Primary practice location

209 Highway 314 NW
Los Lunas, NM 87031-6697

Mailing address

PO Box 2927
Los Lunas, NM 87031-2927
Phone (505) 865-7610

Other identifiers 2

IdentifierTypeStateIssuer
00KP19OtherNMBC/BS
201000668OtherNMPRESBYTERIAN

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1157932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408060800000",
    "number": "1215031257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2927",
            "city": "LOS LUNAS",
            "state": "NM",
            "postal_code": "870312927",
            "telephone_number": "505-865-7610",
            "fax_number": "505-865-8673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 HIGHWAY 314 NW",
            "city": "LOS LUNAS",
            "state": "NM",
            "postal_code": "870316697",
            "telephone_number": "505-865-7610",
            "fax_number": "505-865-8673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENDER",
        "first_name": "JEFFREY",
        "middle_name": "L",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-11",
        "last_updated": "2014-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NM",
            "license": "1247",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "00KP19",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRESBYTERIAN",
            "identifier": "201000668",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Lunas, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2014; 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.