Individual provider Active NPI

Jacob Hyde Hansen, DC

  • Chiropractor
  • Castle Rock, CO
National Provider Identifier
1548568629
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHR0007032 Issued in CO
Practice address
4625 Trail Boss Dr
Castle Rock, CO 80104-2803
Phone
(925) 449-3356
Fax
(925) 449-5229
NPI assigned
Mar 14, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CHR0007032 CO Primary
Chiropractor 111N00000X DC31942 CA

Addresses

Primary practice location

4625 Trail Boss Dr
Castle Rock, CO 80104-2803

Mailing address

4625 Trail Boss Dr
Castle Rock, CO 80104-2803
Phone (720) 893-2225

Other identifiers 1

IdentifierTypeStateIssuer
821009639OtherWAITING FOR MEDICARE NUMBER TO COME THROUGH

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
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
CHR0007032COMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Alexander Chiropractic Center Inc. Chiropractor PastSince Jul 1, 1999 Accepting new patients
Alexander Chiropractic and Wellness Inc. Chiropractor PastSince Sep 26, 2018 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": "1300060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1548568629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4625 TRAIL BOSS DR",
            "city": "CASTLE ROCK",
            "state": "CO",
            "postal_code": "801042803",
            "telephone_number": "720-893-2225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4625 TRAIL BOSS DR",
            "city": "CASTLE ROCK",
            "state": "CO",
            "postal_code": "801042803",
            "telephone_number": "925-449-3356",
            "fax_number": "925-449-5229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANSEN",
        "first_name": "JACOB",
        "middle_name": "HYDE",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-03-14",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CO",
            "license": "CHR0007032",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC31942",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WAITING FOR MEDICARE NUMBER TO COME THROUGH",
            "identifier": "821009639",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Castle Rock, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.