Individual provider Active NPI

Jacob Beto Quihuis, D.C.

  • Chiropractor
  • Santa Rosa, CA
National Provider Identifier
1568400240
Registry record updated Apr 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC29966 Issued in CA
Practice address
845 4TH St
Santa Rosa, CA 95404-4504
Phone
(707) 523-9850
Fax
(707) 523-9848
NPI assigned
Jun 3, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 19, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC29966 CA Primary

Addresses

Primary practice location

845 4TH St
Santa Rosa, CA 95404-4504

Mailing address

845 4TH St
Santa Rosa, CA 95404-4504
Phone (707) 523-9850

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060403000786 CA Practitioner - Chiropractic 8224046149 Practice locations: Santa Rosa, CA

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Western States College of Chiropractic, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

845 4TH St
Santa Rosa, CA 95404-4504
Phone (707) 523-9850

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC29966CAMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1149292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524096000000",
    "number": "1568400240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "845 4TH ST",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954044504",
            "telephone_number": "707-523-9850",
            "fax_number": "707-523-9848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "845 4TH ST",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954044504",
            "telephone_number": "707-523-9850",
            "fax_number": "707-523-9848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUIHUIS",
        "first_name": "JACOB",
        "middle_name": "BETO",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-03",
        "last_updated": "2018-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC29966",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2018; 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.