Individual provider Active NPI

Jonathan L Becerra Lopez, DC

  • Chiropractor
  • Coamo, PR
National Provider Identifier
1487416616
Registry record updated Dec 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4913 Issued in SC
Practice address
40 Calle Florencio Santiago
Coamo, PR 00769-3208
Phone
(787) 648-1863
NPI assigned
Jan 24, 2024
Last updated
Dec 3, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4913 SC Primary

Addresses

Primary practice location

40 Calle Florencio Santiago
Coamo, PR 00769-3208

Mailing address

Ext Jard de Coamo
Calle 13 F2
Coamo, PR 00769
Phone (787) 648-1863

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, PR2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240515003622 SC Practitioner - Chiropractic 2365883790
I20241231001773 PR Practitioner - Chiropractic 2365883790

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
963PRMDSpeech-Language Pathologist
4913SCMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Quest Chiropractic LLC Chiropractor CurrentSince Jul 13, 2025 Accepting new patients
Maxima Chiropractic Clinic Chiropractor CurrentSince Nov 3, 2024 Accepting new patients

Locations

40 Calle Florencio Santiago
Coamo, PR 00769
Phone (787) 648-1863

8 W Lewis Plz
Greenville, SC 29605
Phone (864) 263-3020

8 W Lewis Plz
#8
Greenville, SC 29605

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1706054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733184000000",
    "number": "1487416616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "EXT JARD DE COAMO",
            "address_2": "CALLE 13 F2",
            "city": "COAMO",
            "state": "PR",
            "postal_code": "00769",
            "telephone_number": "787-648-1863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 CALLE FLORENCIO SANTIAGO",
            "city": "COAMO",
            "state": "PR",
            "postal_code": "007693208",
            "telephone_number": "787-648-1863"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BECERRA LOPEZ",
        "first_name": "JONATHAN",
        "middle_name": "L",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-01-24",
        "last_updated": "2024-12-03",
        "certification_date": "2024-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "SC",
            "license": "4913",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coamo, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2024; 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.