Active NPI
Jeffrey R McIntyre, D. C.
- Chiropractor
- Anderson, IN
National Provider Identifier
1376772525
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 08002470A
- Practice address
- 1541 S Scatterfield Rd
Ste a
Anderson, IN 46016-5784 - Phone
- (765) 649-1991
- Fax
- (765) 649-3383
- NPI assigned
- Jul 9, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 08002470A | IN | Primary |
Addresses
Primary practice location
1541 S Scatterfield Rd
Ste a
Anderson, IN 46016-5784
Mailing address
407 E Market St
Ste 102
Crawfordsville, IN 47933-1852
Phone (765) 362-1500
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200959690 | Medicaid | IN | |
| 000000729295 | Other | IN | ANTHEM INDIVIDUAL PIN |
| M400055076 | Other | IN | MEDICARE PTAN INDIVIDUAL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20091014000363 | IN | Practitioner - Chiropractic | 6507902087 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Logan College of Chiropractic, 2008
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Chiromed Plus LLC
Practice addresses (Care Compare)
407 E Market St
Suite 102
Crawfordsville, IN 47933-1852
Phone (765) 362-1500
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 08002470A | IN | MD | Chiropractor |
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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1247097600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1477267200000",
"number": "1376772525",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "407 E MARKET ST",
"address_2": "STE 102",
"city": "CRAWFORDSVILLE",
"state": "IN",
"postal_code": "479331852",
"telephone_number": "765-362-1500",
"fax_number": "765-361-8919"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1541 S SCATTERFIELD RD",
"address_2": "STE A",
"city": "ANDERSON",
"state": "IN",
"postal_code": "460165784",
"telephone_number": "765-649-1991",
"fax_number": "765-649-3383"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCINTYRE",
"first_name": "JEFFREY",
"middle_name": "R",
"name_prefix": "Dr.",
"credential": "D. C.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-07-09",
"last_updated": "2016-10-24",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "IN",
"license": "08002470A",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200959690",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM INDIVIDUAL PIN",
"identifier": "000000729295",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PTAN INDIVIDUAL",
"identifier": "M400055076",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Anderson, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2016; 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.