Individual provider Active NPI

Jeremy Sean Deherrera, D.C.

  • Chiropractor
  • Billings, MT
National Provider Identifier
1306240080
Registry record updated Oct 9, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHI-CHI-LIC-3416 Issued in MT
Practice address
1643 24TH St W
Ste 203
Billings, MT 59102-2677
Phone
(406) 652-5140
Fax
(406) 294-2822
NPI assigned
Oct 9, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 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 CHI-CHI-LIC-3416 MT Primary

Addresses

Primary practice location

1643 24TH St W
Ste 203
Billings, MT 59102-2677

Mailing address

1643 24TH St W
Ste 203
Billings, MT 59102-2677
Phone (406) 652-5140

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141108000263 MT Practitioner - Chiropractic 6901027242 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Western States College of Chiropractic, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1595 Grand Ave
Suite 200
Billings, MT 59102-3055
Phone (406) 652-5140

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CHI-CHI-LIC-3416MTMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Move More Performance - Wellness - Rehab CurrentSince May 25, 2021 Accepting new patients
Back in Motion Chiropractic LLC Chiropractor CurrentSince Sep 21, 2014 Accepting new patients

Locations

1643 24th St W
Ste 203
Billings, MT 59102
Phone (406) 272-2209

1595 Grand Ave
Ste 200
Billings, MT 59102
Phone (406) 652-5140

Organizations & group practices 2

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": "1412812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412812800000",
    "number": "1306240080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1643 24TH ST W",
            "address_2": "STE 203",
            "city": "BILLINGS",
            "state": "MT",
            "postal_code": "591022677",
            "telephone_number": "406-652-5140",
            "fax_number": "406-294-2822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1643 24TH ST W",
            "address_2": "STE 203",
            "city": "BILLINGS",
            "state": "MT",
            "postal_code": "591022677",
            "telephone_number": "406-652-5140",
            "fax_number": "406-294-2822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEHERRERA",
        "first_name": "JEREMY",
        "middle_name": "SEAN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-10-09",
        "last_updated": "2014-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MT",
            "license": "CHI-CHI-LIC-3416",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Billings, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2014; 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.