Individual provider Active NPI

Jill Suzanne Harbin, DC

  • Chiropractor
  • Madison, AL
National Provider Identifier
1588042410
Registry record updated Jan 25, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2459 Issued in AL
Practice address
970 Balch Rd
Madison, AL 35758-9715
Phone
(256) 527-5564
Fax
(256) 365-3406
NPI assigned
May 12, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 25, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2459 AL Primary

Addresses

Primary practice location

970 Balch Rd
Madison, AL 35758-9715

Mailing address

2114 Smoketree TRL NE
Huntsville, AL 35811-2614
Phone (256) 682-0411

Other identifiers 3

IdentifierTypeStateIssuer
JH1200857OtherALAMERICAN SPECIALTY HEALTH GROUP
025567OtherALOPTUM
511-64509OtherALBLUE CROSS BLUE SHIELD

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
2459ALMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1431388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485302400000",
    "number": "1588042410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2114 SMOKETREE TRL NE",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358112614",
            "telephone_number": "256-682-0411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "970 BALCH RD",
            "city": "MADISON",
            "state": "AL",
            "postal_code": "357589715",
            "telephone_number": "256-527-5564",
            "fax_number": "256-365-3406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARBIN",
        "first_name": "JILL",
        "middle_name": "SUZANNE",
        "name_prefix": "Miss",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-05-12",
        "last_updated": "2017-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AL",
            "license": "2459",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICAN SPECIALTY HEALTH GROUP",
            "identifier": "JH1200857",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTUM",
            "identifier": "025567",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "511-64509",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2017; 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.