Denise Mathre Chiropractic Corporation

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

DC24828 Issued in CA

Legal business name

DENISE MATHRE CHIROPRACTIC CORPORATION

Practice address

12150 Industry Blvd Ste 45
Jackson, CA 95642-9375

Phone

(209) 223-4442

Fax

(209) 231-5144

NPI assigned

Jan 12, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Denise Mathre, DCNPI 1376643106

Title

Owner

Phone

(209) 223-4442

Specialties & licenses 1

Addresses

Other names 1

• Achieving Balance Chiropractic Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Denise P. Mathre, D.C.

  • Chiropractor
  • Jackson, CA
  • NPI 1376643106

  CA, Chiropractor

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1389484800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1389484800000",
    "number": "1346662269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12150 INDUSTRY BLVD STE 45",
            "city": "JACKSON",
            "state": "CA",
            "postal_code": "956429375",
            "telephone_number": "209-223-4442",
            "fax_number": "209-231-5144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12150 INDUSTRY BLVD STE 45",
            "city": "JACKSON",
            "state": "CA",
            "postal_code": "956429375",
            "telephone_number": "209-223-4442",
            "fax_number": "209-231-5144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENISE MATHRE CHIROPRACTIC CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-12",
        "last_updated": "2014-01-12",
        "status": "A",
        "authorized_official_last_name": "MATHRE",
        "authorized_official_first_name": "DENISE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "209-223-4442",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC24828",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Achieving Balance Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Romeo Dipasupil, DDS

• All providers in Jackson, CA
• Chiropractor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.