Active NPI
Jesse J Allen, DC
- Chiropractor
- Fremont, CA
National Provider Identifier
1396824751
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 17973
- Practice address
- 40000 Fremont Blvd Ste H
Fremont, CA 94538-2978 - Phone
- (510) 790-1000
- Fax
- (510) 770-0145
- NPI assigned
- Nov 3, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 | 17973 | CA | Primary |
Addresses
Primary practice location
40000 Fremont Blvd Ste H
Fremont, CA 94538-2978
Mailing address
40000 Fremont Blvd Ste H
Fremont, CA 94538-2978
Phone (510) 790-1000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120220000046 | CA | Practitioner - Chiropractic | 3971761149 | Practice locations: Fremont, CA |
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Life Chiropractic College - West, 1986
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
40000 Fremont Blvd
Suite G
Fremont, CA 94538-2978
Phone 5104389211510
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162512000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1396824751",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "40000 FREMONT BLVD STE H",
"city": "FREMONT",
"state": "CA",
"postal_code": "945382978",
"telephone_number": "510-790-1000",
"fax_number": "510-770-0145"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "40000 FREMONT BLVD STE H",
"city": "FREMONT",
"state": "CA",
"postal_code": "945382978",
"telephone_number": "510-790-1000",
"fax_number": "510-770-0145"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ALLEN",
"first_name": "JESSE",
"middle_name": "J",
"credential": "DC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-11-03",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "CA",
"license": "17973",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fremont, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.