Individual provider Active NPI

Zhijia Jack Qiu, D.C.

  • Chiropractor
  • Bullhead City, AZ
National Provider Identifier
1306171954
Registry record updated Jan 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
8188 Issued in AZ
Practice address
2440 Highway 95, Suite a
Bullhead City, AZ 86442
Phone
(928) 704-2225
Fax
(928) 704-0402
NPI assigned
Oct 14, 2009
Last updated
Jan 24, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 24, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038011396 IL
Chiropractor 111N00000X 8188 AZ Primary

Addresses

Primary practice location

2440 Highway 95, Suite a
Bullhead City, AZ 86442

Mailing address

2440 Highway 95, Suite a
Bullhead City, AZ 86442
Phone (928) 704-2225

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
038011396ILMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Travis Enterprises LLC Chiropractor CurrentSince May 1, 2024 Accepting new patients
Mark E. Lee,D.C.,P.C. Chiropractor PastSince Aug 15, 2010 Accepting new patients
Kukurin Chiropractic Past Accepting new patients

Locations

2440 Highway 95
Ste A
Bullhead City, AZ 86442
Phone (928) 704-2225

Organizations & group practices 3

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": "1255478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1516752000000",
    "number": "1306171954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2440 HIGHWAY 95, SUITE A",
            "city": "BULLHEAD CITY",
            "state": "AZ",
            "postal_code": "86442",
            "telephone_number": "928-704-2225",
            "fax_number": "928-704-0402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2440 HIGHWAY 95, SUITE A",
            "city": "BULLHEAD CITY",
            "state": "AZ",
            "postal_code": "86442",
            "telephone_number": "928-704-2225",
            "fax_number": "928-704-0402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QIU",
        "first_name": "ZHIJIA",
        "middle_name": "JACK",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-10-14",
        "last_updated": "2018-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038011396",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AZ",
            "license": "8188",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bullhead City, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2018; 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.