Individual provider Active NPI

Jason Cody Squyres, D.C.

  • Chiropractor
  • Justin, TX
National Provider Identifier
1275838120
Registry record updated Mar 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
11522 Issued in TX
Practice address
15080 Hwy 156
Suite C
Justin, TX 76247
Phone
(940) 242-6641
Fax
(940) 242-6642
NPI assigned
Jan 24, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 20, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 11522 TX Primary

Addresses

Primary practice location

15080 Hwy 156
Suite C
Justin, TX 76247

Mailing address

15080 Hwy 156
Suite C
Justin, TX 76247
Phone (940) 242-6641

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110630000565 TX Practitioner - Chiropractic 4082892690 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

15080 FM
156 Suite B
Justin, TX 76247-7924
Phone (940) 242-6641

15080 FM 156 B
Justin, TX 76247-7924

204 N Jackson
Justin, TX 76247-9582

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1295827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489968000000",
    "number": "1275838120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15080 HWY 156",
            "address_2": "SUITE C",
            "city": "JUSTIN",
            "state": "TX",
            "postal_code": "76247",
            "telephone_number": "940-242-6641",
            "fax_number": "940-242-6642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15080 HWY 156",
            "address_2": "SUITE C",
            "city": "JUSTIN",
            "state": "TX",
            "postal_code": "76247",
            "telephone_number": "940-242-6641",
            "fax_number": "940-242-6642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SQUYRES",
        "first_name": "JASON",
        "middle_name": "CODY",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-01-24",
        "last_updated": "2017-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "11522",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Justin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 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.