Omer Chiropractic Clinic PC
Organization Active NPI Chiropractor · Washington, IN
NPI 1457540155 · NPPES record last updated Sep 15, 2014
Key facts
- NPI
- 1457540155
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Chiropractor 111N00000X
- License
- 08001596 (IN)
- Legal business name
- OMER CHIROPRACTIC CLINIC PC
- Practice address
- 501 SE 2ND St
Washington, IN 47501-4043 - Phone
- (812) 254-0476
- Fax
- (812) 254-0477
- NPI assigned
- Oct 18, 2007
- Organization subpart
- No
Authorized official
- Name
- Dr. Jason Omer, D.C.
- Title
- Owner/Chiropractor
- Phone
- (812) 254-0476
Practitioners 4
-
Jason Omer, D.C.
-
Leslie Starr-Omer, D.C.
-
Jordan Kyle Hawkins, D.C.
-
Leslie B Hawkins, D.C.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20080109000594 | IN | Part B Supplier - Clinic/Group Practice | 0446330906 |
Receives reassigned benefits from 2 practitioners Practice locations: Washington, IN |
National Provider Directory
Locations
211 SE 1st St
Loogootee, IN 47553
Phone (812) 295-3346
501 SE 2nd St
Washington, IN 47501
Phone (812) 254-0476
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor |
111N00000X | 08001596 | IN | Yes |
Addresses
Primary practice location
501 SE 2ND St
Washington, IN 47501-4043
Mailing address
501 SE 2ND St
Washington, IN 47501-4043
Phone (812) 254-0476
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200025970A | Medicaid | IN | |
| 000000184810 | Other | IN | ANTHEM BLUE CROSS BLUE SH |
Other providers in Washington, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 15, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.