Organization Active NPI

Jeffrey M Jernberg, D.C., P.C.

  • Chiropractor
  • Sioux City, IA
National Provider Identifier
1598047722
Registry record updated Sep 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
06265 Issued in IA
Legal business name
JEFFREY M JERNBERG, D.C., P.C.
Practice address
4281 Sergeant Rd
Sioux City, IA 51106-4625
Phone
(712) 274-6695
Fax
(712) 274-6699
NPI assigned
Sep 14, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2011

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

Authorized official

Name
Dr. Jeffrey Michael Jernberg, D.C.NPI 1942293378
Title
Owner
Phone
(712) 274-6695

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 06265 IA Primary

Addresses

Primary practice location

4281 Sergeant Rd
Sioux City, IA 51106-4625

Mailing address

4281 Sergeant Rd
Sioux City, IA 51106-4625
Phone (712) 274-6695

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111010000440 IA Part B Supplier - Clinic/Group Practice 7911179205 Receives reassigned benefits from 1 practitioner
Practice locations: Sioux City, IA

National Provider Directory

National Provider Directory

Locations

4281 Sergeant Rd
Sioux City, IA 51106
Phone (712) 274-6695

4719 Southern Hills Dr
Sioux City, IA 51106
Phone (712) 274-6695

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1315958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1315958400000",
    "number": "1598047722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4281 SERGEANT RD",
            "city": "SIOUX CITY",
            "state": "IA",
            "postal_code": "511064625",
            "telephone_number": "712-274-6695",
            "fax_number": "712-274-6699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4281 SERGEANT RD",
            "city": "SIOUX CITY",
            "state": "IA",
            "postal_code": "511064625",
            "telephone_number": "712-274-6695",
            "fax_number": "712-274-6699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFREY M JERNBERG, D.C., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-14",
        "last_updated": "2011-09-14",
        "status": "A",
        "authorized_official_last_name": "JERNBERG",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "712-274-6695",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "IA",
            "license": "06265",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sioux City, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.