Individual provider Active NPI

Jonathan C Gerber, D.C.

  • Chiropractor
  • Queensbury, NY
National Provider Identifier
1457326902
Registry record updated May 20, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
X011021-1 Issued in NY
Practice address
12 Haviland Road
Queensbury, NY 12804-9720
Phone
(518) 793-5555
Fax
(518) 793-5551
NPI assigned
Feb 20, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 20, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X X011021-1 NY Primary

Addresses

Primary practice location

12 Haviland Road
Queensbury, NY 12804-9720

Mailing address

12 Haviland Road
Queensbury, NY 12804-9720
Phone (518) 793-5555

Other identifiers 2

IdentifierTypeStateIssuer
C11021-SWOtherNYWORKER'S COMP
C11021-5WOtherNYWORKER'S COMP

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
X011021-1NYMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Tackett Chiropractic, P.C. Chiropractor PastSince Jun 1, 2003 Accepting new patients
Lockhart Chiropractic, PC Chiropractor Past Accepting new patients

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": "1140393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1242777600000",
    "number": "1457326902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 HAVILAND ROAD",
            "city": "QUEENSBURY",
            "state": "NY",
            "postal_code": "128049720",
            "telephone_number": "518-793-5555",
            "fax_number": "518-793-5551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 HAVILAND ROAD",
            "city": "QUEENSBURY",
            "state": "NY",
            "postal_code": "128049720",
            "telephone_number": "518-793-5555",
            "fax_number": "518-793-5551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GERBER",
        "first_name": "JONATHAN",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-20",
        "last_updated": "2009-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X011021-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WORKER'S COMP",
            "identifier": "C11021-SW",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WORKER'S COMP",
            "identifier": "C11021-5W",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Queensbury, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2009; 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.