Jacob David Madock, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

S04154 Issued in MD

Practice address

9093 Ridgefield Dr Ste 107
Frederick, MD 21701-6711

Phone

(301) 620-8566

Fax

(301) 620-8568

NPI assigned

Nov 16, 2022

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 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1668556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668556800000",
    "number": "1427767607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9093 RIDGEFIELD DR STE 107",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217016711",
            "telephone_number": "301-620-8566",
            "fax_number": "301-620-8568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9093 RIDGEFIELD DR STE 107",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217016711",
            "telephone_number": "301-620-8566",
            "fax_number": "301-620-8568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADOCK",
        "first_name": "JACOB",
        "middle_name": "DAVID",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-11-16",
        "last_updated": "2022-11-16",
        "certification_date": "2022-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MD",
            "license": "S04154",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "S04154",
            "state": "MD"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "billing@springridgechiroactic.com",
            "affiliation": "N",
            "endpointDescription": "email address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "9093 Ridgefield Dr Ste 107",
            "city": "Frederick",
            "state": "MD",
            "country_code": "US",
            "postal_code": "217016711",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Macmurray Behavioral Healthcare LLC.
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• Kate Macshane, LCSW-C
• Jehangir Madan, N.P. - B.C.
• Jackson Maddox, RBT
• William Magdalin, LMSW
• Magic Touch Solutions LLC
• Magnifind Solutions LLC
• Magnolia Behavior Health Center LLC
• Magnolia Behavior Health Center LLC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2022; 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.