Active NPI
Jed Wilburn, D.C.
- Chiropractor
- Redding, CA
National Provider Identifier
1497775126
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- DC28198
- Practice address
- 1556 Hartnell Ave Ste D
Redding, CA 96002-2277 - Phone
- (530) 241-0712
- Fax
- (530) 222-5837
- NPI assigned
- Jul 19, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | DC28198 | CA | Primary |
Addresses
Primary practice location
1556 Hartnell Ave Ste D
Redding, CA 96002-2277
Mailing address
1556 Hartnell Ave Ste D
Redding, CA 96002-2277
Phone (530) 241-0712
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| DC0281980 | Medicaid | CA | |
| DC0281980 | Other | CA | BLUE SHIELD OF CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20061101000180 | CA | Practitioner - Chiropractic | 3971500174 | Practice locations: Redding, CA |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DC28198 | CA | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153267200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1707177600000",
"number": "1497775126",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1556 HARTNELL AVE STE D",
"city": "REDDING",
"state": "CA",
"postal_code": "960022277",
"telephone_number": "530-241-0712",
"fax_number": "530-222-5837"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1556 HARTNELL AVE STE D",
"city": "REDDING",
"state": "CA",
"postal_code": "960022277",
"telephone_number": "530-241-0712",
"fax_number": "530-222-5837"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILBURN",
"first_name": "JED",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-19",
"last_updated": "2024-02-06",
"certification_date": "2024-02-06",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "CA",
"license": "DC28198",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "DC0281980",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD OF CA",
"identifier": "DC0281980",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Redding, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 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.