Complete Chiropractics LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

761 Issued in WY

Legal business name

COMPLETE CHIROPRACTICS LLC

Practice address

170 Commerce Dr Ste a
Green River, WY 82935-6156

Phone

(307) 875-4325

NPI assigned

Jan 11, 2017

Last updated

Jan 11, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jacob Glen Smith, D.C.NPI 1255790788

Title

Owner

Phone

(307) 875-4325

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WY

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, and the practitioner matching its NPPES authorized official.

• Jacob Glen Smith, D.C.

  • Chiropractor
  • Green River, WY
  • NPI 1255790788
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1484092800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1484092800000",
    "number": "1376089581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "170 COMMERCE DR STE A",
            "city": "GREEN RIVER",
            "state": "WY",
            "postal_code": "829356156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 COMMERCE DR STE A",
            "city": "GREEN RIVER",
            "state": "WY",
            "postal_code": "829356156",
            "telephone_number": "307-875-4325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPLETE CHIROPRACTICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-11",
        "last_updated": "2017-01-11",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "JACOB",
        "authorized_official_middle_name": "GLEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "307-875-4325",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WY",
            "license": "761",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Castle Rock Special Hospital District
• Castle Rock Special Hospital District (Castle Rock Hospital District)
• Castle Rock Special Hospital District
• Charles R. Vandervort, O.D., P.C. (Eye Care Specialists of Green River)
• Community Nursing Service
• Haylen R Cordova, DPT, PT
• Kendahl Coy
• Cynthia C Crider, LPC
• Yolanda Y Crowder, LCSW, RPT-S
• D. Wayne Birch, D.D.S., P.C.

• Chiropractor in Green River, WY
• Providers in Green River, WY by specialty
• Chiropractor in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2017; 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.