Individual provider Active NPI

Jason Holt Mavor, D.C.

  • Chiropractor
  • Watertown, MA
National Provider Identifier
1619134954
Registry record updated Jun 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3254 Issued in MA
Practice address
279 Mount Auburn St
Watertown, MA 02472-1955
Phone
(617) 393-3472
Fax
(617) 393-3473
NPI assigned
May 22, 2008
Last updated
Jun 3, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 3, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 30920 CA
Chiropractor 111N00000X 3254 MA Primary

Addresses

Primary practice location

279 Mount Auburn St
Watertown, MA 02472-1955

Mailing address

279 Mount Auburn St
Watertown, MA 02472-1955
Phone (617) 393-3472

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100902000283 MA Practitioner - Chiropractic 0840331690 Practice locations: Watertown, MA

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Western States College of Chiropractic, 2007
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

279 Mount Auburn St
Watertown, MA 02472-1955
Phone (617) 393-3472

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3254MAMDBehavioral Analyst
30920CAMDCommunity Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Main Street Chiropractic, LLC Chiropractor Past Accepting new patients
Main Street Chiropractic Chiropractor Past Accepting new patients
Gait Way to Wellness Physical Therapy PastSince Mar 19, 2025 Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1211414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780444800000",
    "number": "1619134954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "279 MOUNT AUBURN ST",
            "city": "WATERTOWN",
            "state": "MA",
            "postal_code": "024721955",
            "telephone_number": "617-393-3472",
            "fax_number": "617-393-3473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "279 MOUNT AUBURN ST",
            "city": "WATERTOWN",
            "state": "MA",
            "postal_code": "024721955",
            "telephone_number": "617-393-3472",
            "fax_number": "617-393-3473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAVOR",
        "first_name": "JASON",
        "middle_name": "HOLT",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-05-22",
        "last_updated": "2026-06-03",
        "certification_date": "2026-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "30920",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MA",
            "license": "3254",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Watertown, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2026; 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.