Individual provider Active NPI

David Jeremy Mayes, D.C.

  • Chiropractor
  • Columbia, MO
National Provider Identifier
1528368552
Registry record updated Oct 25, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2010035892 Issued in MO
Practice address
4603 John Garry Dr
Suite 11
Columbia, MO 65203-6834
Phone
(573) 442-0286
NPI assigned
Oct 25, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 25, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2010035892 MO Primary

Addresses

Primary practice location

4603 John Garry Dr
Suite 11
Columbia, MO 65203-6834

Mailing address

1604 Skylane Dr
Columbia, MO 65202-1711
Phone (913) 645-6773

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120822000681 WA Practitioner - Chiropractic 3375790553 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Cleveland Chiropractic College - Kansas City, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bellevue Chiropractic PSGroup PAC ID 8123010048, 5 clinicians

Practice addresses (Care Compare)

1800 116TH Ave NE
Suite 101
Bellevue, WA 98004-3043
Phone (425) 637-0094

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2010035892MOMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Bellevue Chiropractic PS Chiropractor CurrentSince Jul 18, 2012 Accepting new patients
The Center for Oral & Maxillofacial Surgery PastSince Jul 18, 2012 Accepting new patients

Locations

1800 116th Ave NE
Ste 101
Bellevue, WA 98004
Phone (425) 454-5091

320 106th Ave NE
Ste A
Bellevue, WA 98004
Phone (206) 362-1111

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": "1287964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287964800000",
    "number": "1528368552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1604 SKYLANE DR",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652021711",
            "telephone_number": "913-645-6773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4603 JOHN GARRY DR",
            "address_2": "SUITE 11",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652036834",
            "telephone_number": "573-442-0286"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYES",
        "first_name": "DAVID",
        "middle_name": "JEREMY",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-10-25",
        "last_updated": "2010-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "2010035892",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.