Jerry Lee Radas, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

SO1592 Issued in MD

Practice address

7625 Maple Lawn Blvd
Suite 160
Fulton, MD 20759-2565

Phone

(301) 490-8550

Fax

(301) 490-8581

NPI assigned

Sep 29, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MD

Enrollment records 1

Specialty

Chiropractic

Education

Logan College of Chiropractic, 1992

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Jerry L. Radas, P.C.

  dba Fulton Family Chiropractic

  • Chiropractor
  • Fulton, MD
  • NPI 1538350855
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1295913600000",
    "number": "1396837753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7625 MAPLE LAWN BLVD",
            "address_2": "SUITE 160",
            "city": "FULTON",
            "state": "MD",
            "postal_code": "207592565",
            "telephone_number": "301-490-8550",
            "fax_number": "301-490-8581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7625 MAPLE LAWN BLVD",
            "address_2": "SUITE 160",
            "city": "FULTON",
            "state": "MD",
            "postal_code": "207592565",
            "telephone_number": "301-490-8550",
            "fax_number": "301-490-8581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RADAS",
        "first_name": "JERRY",
        "middle_name": "LEE",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-29",
        "last_updated": "2011-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MD",
            "license": "SO1592",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST BCBS",
            "identifier": "M123JL",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST BCBS",
            "identifier": "W3530001",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Fulton, MD
• Providers in Fulton, MD by specialty
• Chiropractor in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2011; 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.