Individual provider Active NPI

Jerrell John Hardison, DC

  • Chiropractor
  • Pittsburgh, PA
National Provider Identifier
1558825489
Registry record updated Jan 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC011451 Issued in PA
Practice address
9000 Perry Hwy
Pittsburgh, PA 15237-5367
Phone
(412) 367-2165
Fax
(412) 367-2183
NPI assigned
Jan 24, 2019
Last updated
Jan 24, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC011451 PA Primary

Addresses

Primary practice location

9000 Perry Hwy
Pittsburgh, PA 15237-5367

Mailing address

544 Craighead St Apt D
Canonsburg, PA 15317-1746
Phone (814) 244-1009

Other practice location 1

3540 Washington Rd
Mc Murray, PA 15317-2957
Phone (724) 941-0707

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC011451PAMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1548288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548288000000",
    "number": "1558825489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "544 CRAIGHEAD ST APT D",
            "city": "CANONSBURG",
            "state": "PA",
            "postal_code": "153171746",
            "telephone_number": "814-244-1009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9000 PERRY HWY",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152375367",
            "telephone_number": "412-367-2165",
            "fax_number": "412-367-2183"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3540 Washington Rd",
            "address_purpose": "LOCATION",
            "city": "Mc Murray",
            "state": "PA",
            "postal_code": "153172957",
            "country_code": "US",
            "telephone_number": "724-941-0707",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARDISON",
        "first_name": "JERRELL",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-01-24",
        "last_updated": "2019-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "PA",
            "license": "DC011451",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pittsburgh, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2019; 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.