Individual provider Active NPI

John P Degenhart, DC

  • Chiropractor
  • Hazleton, PA
National Provider Identifier
1356352652
Registry record updated Feb 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC002134L Issued in PA
Practice address
1749 E Broad St
Hazleton, PA 18201
Phone
(570) 454-2474
Fax
(570) 454-0097
NPI assigned
Aug 11, 2006
Last updated
Feb 4, 2013By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 4, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC002134L PA Primary

Addresses

Primary practice location

1749 E Broad St
Hazleton, PA 18201

Mailing address

1749 E Broad St
Hazleton, PA 18201
Phone (570) 454-2474

Other identifiers 1

IdentifierTypeStateIssuer
0008908800001MedicaidPA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040915000745 PA Practitioner - Chiropractic 4688570773 Receives reassigned benefits from 2 practitioners
Practice locations: Hazleton, PA

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1749 E Broad St
Hazleton, PA 18201-5650

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
John P Degenhart Chiropractor PastSince Apr 29, 2004 Accepting new patients

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

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, 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": "1155254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359936000000",
    "number": "1356352652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1749 E BROAD ST",
            "city": "HAZLETON",
            "state": "PA",
            "postal_code": "18201",
            "telephone_number": "570-454-2474",
            "fax_number": "570-454-0097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1749 E BROAD ST",
            "city": "HAZLETON",
            "state": "PA",
            "postal_code": "18201",
            "telephone_number": "570-454-2474",
            "fax_number": "570-454-0097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEGENHART",
        "first_name": "JOHN",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-11",
        "last_updated": "2013-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "PA",
            "license": "DC002134L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0008908800001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hazleton, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2013; 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.