Individual provider Active NPI

Edward W Levin Jr., D.C.

  • Chiropractor
  • Lafayette, LA
National Provider Identifier
1265763387
Registry record updated Jan 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1290 Issued in LA
Practice address
2701 Johnston St
Suite 100
Lafayette, LA 70503-3263
Phone
(337) 261-2633
Fax
(337) 261-3766
NPI assigned
Jan 29, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 9, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1290 LA Primary

Addresses

Primary practice location

2701 Johnston St
Suite 100
Lafayette, LA 70503-3263

Mailing address

410 N 7TH St
West Monroe, LA 71291-4108
Phone (318) 303-6142

Other identifiers 1

IdentifierTypeStateIssuer
1290OtherLAMEDICAL LICENSE

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

LicenseStateTypeSpecialty
657MTMDOptometrist
1290LAMDHearing Instrument Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
JDH Management LLC Chiropractor CurrentSince Jan 1, 2023 Accepting new patients

Locations

801 Johnson St
Tallulah, LA 71282
Phone (318) 303-6142

403 N 6th St
Ste 8
West Monroe, LA 71291
Phone (318) 303-6142

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": "1264723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673222400000",
    "number": "1265763387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 N 7TH ST",
            "city": "WEST MONROE",
            "state": "LA",
            "postal_code": "712914108",
            "telephone_number": "318-303-6142",
            "fax_number": "318-855-8453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701 JOHNSTON ST",
            "address_2": "SUITE 100",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705033263",
            "telephone_number": "337-261-2633",
            "fax_number": "337-261-3766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEVIN",
        "first_name": "EDWARD",
        "middle_name": "W",
        "name_suffix": "Jr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-01-29",
        "last_updated": "2023-01-09",
        "certification_date": "2023-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "LA",
            "license": "1290",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "1290",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2023; 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.