Individual provider Active NPI

Jeffrey Gannon O'Hara, D.C.

  • Rehabilitation Chiropractor
  • Windsor, CO
National Provider Identifier
1477832194
Registry record updated Aug 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation ChiropractorTaxonomy code 111NR0400X
License
CHR6717 Issued in CO
Practice address
1180 Main St Unit 7
Windsor, CO 80550-4753
Phone
(970) 744-1084
NPI assigned
Aug 11, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 11, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Chiropractor 111NR0400X CHR6717 CO Primary

Addresses

Primary practice location

1180 Main St Unit 7
Windsor, CO 80550-4753

Mailing address

1180 Main St Unit 7
Windsor, CO 80550-4753
Phone (970) 744-1084

Other identifiers 1

IdentifierTypeStateIssuer
CHR6717OtherCOCHR6717

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
CHR6717COMDRehabilitation Chiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Clinical Biomechanics of Posture (CBP) of Colorado a LLC Rehabilitation Past Accepting new patients
Benchmark Medical Group Inc Rehabilitation PastSince Nov 2, 2012 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": "1313020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313020800000",
    "number": "1477832194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1180 MAIN ST UNIT 7",
            "city": "WINDSOR",
            "state": "CO",
            "postal_code": "805504753",
            "telephone_number": "970-744-1084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1180 MAIN ST UNIT 7",
            "city": "WINDSOR",
            "state": "CO",
            "postal_code": "805504753",
            "telephone_number": "970-744-1084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'HARA",
        "first_name": "JEFFREY",
        "middle_name": "GANNON",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-08-11",
        "last_updated": "2011-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Rehabilitation",
            "state": "CO",
            "license": "CHR6717",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHR6717",
            "identifier": "CHR6717",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Windsor, CO

Sources for this page

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