Individual provider Active NPI

Samuel R Jamieson, D.C.

  • Chiropractor
  • San Jose, CA
National Provider Identifier
1558433508
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC25066 Issued in CA
Practice address
1175 Saratoga Ave
Suite 8
San Jose, CA 95129-3440
Phone
(408) 517-0706
Fax
(408) 517-8836
NPI assigned
Nov 14, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC25066 CA Primary

Addresses

Primary practice location

1175 Saratoga Ave
Suite 8
San Jose, CA 95129-3440

Mailing address

1175 Saratoga Ave
Suite 8
San Jose, CA 95129-3440
Phone (408) 517-0706

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070430000225 CA Practitioner - Chiropractic 3375649866 Practice locations: San Jose, CA

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - West Sunnyvale, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1175 Saratoga Ave
Suite 8
San Jose, CA 95129-3427
Phone (408) 517-0706

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC25066CAMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1558433508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1175 SARATOGA AVE",
            "address_2": "SUITE 8",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951293440",
            "telephone_number": "408-517-0706",
            "fax_number": "408-517-8836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1175 SARATOGA AVE",
            "address_2": "SUITE 8",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951293440",
            "telephone_number": "408-517-0706",
            "fax_number": "408-517-8836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAMIESON",
        "first_name": "SAMUEL",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC25066",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.