Jacquellyn Jo Carter, D. C.

Primary specialty

Independent Medical Examiner ChiropractorTaxonomy code 111NI0013X

License

007491 Issued in IA

Practice address

132 Hillside Dr
Eldridge, IA 52748-9637

Phone

(563) 505-7162

NPI assigned

Dec 5, 2011

Last updated

Dec 5, 2011By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1323043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323043200000",
    "number": "1275801201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "132 HILLSIDE DR",
            "city": "ELDRIDGE",
            "state": "IA",
            "postal_code": "527489637",
            "telephone_number": "563-505-7162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "132 HILLSIDE DR",
            "city": "ELDRIDGE",
            "state": "IA",
            "postal_code": "527489637",
            "telephone_number": "563-505-7162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARTER",
        "first_name": "JACQUELLYN",
        "middle_name": "JO",
        "name_prefix": "Dr.",
        "credential": "D. C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-12-05",
        "last_updated": "2011-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NI0013X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Independent Medical Examiner",
            "state": "IA",
            "license": "007491",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Independent Medical Examiner Chiropractor in Eldridge, IA
• Providers in Eldridge, IA by specialty
• Independent Medical Examiner Chiropractor in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2011; 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.