Organization Active NPI

Jennewein Chiropractic, Inc.

  • Chiropractor
  • Lomita, CA
National Provider Identifier
1427104637
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
16429 Issued in CA
Legal business name
JENNEWEIN CHIROPRACTIC, INC.
Practice address
25448 Narbonne Ave
Lomita, CA 90717-2124
Phone
(310) 326-2804
Fax
(310) 534-5166
NPI assigned
Jan 28, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. BJ Jennewein, D.C.NPI 1821142696
Title
President-Owner
Phone
(310) 326-2804

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X 16429 CA Primary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X 15961 CA

Addresses

Primary practice location

25448 Narbonne Ave
Lomita, CA 90717-2124

Mailing address

25448 Narbonne Ave
Lomita, CA 90717-2124
Phone (310) 326-2804

Other names 1

  • JENNEWEIN CHIROPRACTIC, INC. Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080408000504 CA Part B Supplier - Clinic/Group Practice 5597842062 Receives reassigned benefits from 1 practitioner
Practice locations: Lomita, CA

National Provider Directory

National Provider Directory

Locations

25448 Narbonne Ave
Lomita, CA 90717
Phone (310) 326-2804

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1169942400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1427104637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25448 NARBONNE AVE",
            "city": "LOMITA",
            "state": "CA",
            "postal_code": "907172124",
            "telephone_number": "310-326-2804",
            "fax_number": "310-534-5166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25448 NARBONNE AVE",
            "city": "LOMITA",
            "state": "CA",
            "postal_code": "907172124",
            "telephone_number": "310-326-2804",
            "fax_number": "310-534-5166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JENNEWEIN CHIROPRACTIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JENNEWEIN",
        "authorized_official_first_name": "BJ",
        "authorized_official_title_or_position": "PRESIDENT-OWNER",
        "authorized_official_telephone_number": "310-326-2804",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "16429",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "15961",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "JENNEWEIN CHIROPRACTIC, INC.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Lomita, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.