Individual provider Active NPI

Jennifer Ma, DC

  • Chiropractor
  • Lombard, IL
National Provider Identifier
1407131386
Registry record updated Oct 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
03801617 Issued in IL
Practice address
200 East Roosevelt Rd
Lombard, IL 60148
Phone
(630) 889-6453
NPI assigned
Oct 11, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 11, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 03801617 IL Primary

Addresses

Primary practice location

200 East Roosevelt Rd
Lombard, IL 60148

Mailing address

200 East Roosevelt Rd
Lombard, IL 60148
Phone (630) 889-6453

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
03801617ILMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
National University of Health Sciences Chiropractor PastSince Jun 1, 1997 Accepting new patients
Sport & Spine Rehab Institute Chiropractor Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/11209/brand/1/csg/1/fhir/r4

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": "1318291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318291200000",
    "number": "1407131386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 EAST ROOSEVELT RD",
            "city": "LOMBARD",
            "state": "IL",
            "postal_code": "60148",
            "telephone_number": "630-889-6453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 EAST ROOSEVELT RD",
            "city": "LOMBARD",
            "state": "IL",
            "postal_code": "60148",
            "telephone_number": "630-889-6453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MA",
        "first_name": "JENNIFER",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-10-11",
        "last_updated": "2011-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "03801617",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lombard, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.