Individual provider Active NPI

Jason Hunter Cheshire, D.C.

  • Chiropractor
  • Pompano Beach, FL
National Provider Identifier
1366438319
Registry record updated Nov 28, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH0007622 Issued in FL
Practice address
4 NE 4TH Ave
Pompano Beach, FL 33060-6630
Phone
(954) 943-1044
Fax
(954) 943-1014
NPI assigned
Sep 26, 2005
Reactivated
Apr 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH0007622 FL Primary

Addresses

Primary practice location

4 NE 4TH Ave
Pompano Beach, FL 33060-6630

Mailing address

4 NE 4TH Ave
Pompano Beach, FL 33060-6630
Phone (954) 943-1044

Other identifiers 2

IdentifierTypeStateIssuer
55802ZOtherFLBC/BS
5336747OtherFLAETNA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040714000063 FL Practitioner - Chiropractic 2264410877 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lighthouse Medical Center, IncGroup PAC ID 2668706995, 4 clinicians

Practice addresses (Care Compare)

4 NE 4TH Ave
Pompano Beach, FL 33060-6630
Phone (754) 222-6642

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH0007622FLMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Lighthouse Medical Center, Inc. CurrentSince Nov 1, 2018 Accepting new patients
Pompano Beach Chiropractic Clinic, PA Chiropractor CurrentSince Oct 1, 2003 Accepting new patients

Locations

4 NE 4th Ave
Pompano Beach, FL 33060
Phone (754) 222-6642

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1127692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196208000000",
    "number": "1366438319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 NE 4TH AVE",
            "city": "POMPANO BEACH",
            "state": "FL",
            "postal_code": "330606630",
            "telephone_number": "954-943-1044",
            "fax_number": "954-943-1014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 NE 4TH AVE",
            "city": "POMPANO BEACH",
            "state": "FL",
            "postal_code": "330606630",
            "telephone_number": "954-943-1044",
            "fax_number": "954-943-1014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHESHIRE",
        "first_name": "JASON",
        "middle_name": "HUNTER",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-26",
        "last_updated": "2007-11-28",
        "deactivation_date": "2006-03-24",
        "reactivation_date": "2006-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH0007622",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "55802Z",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5336747",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pompano Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2007; 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.