Jeremiah Frederick Sample, D.C., B.S.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

1856 Issued in NE

Practice address

2548 S Dalton St
Wichita, KS 67210-1909

Phone

(316) 214-0720

NPI assigned

Aug 31, 2015

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NE

Enrollment records 1

Specialty

Chiropractic

Education

Palmer College Chiropractic - Davenport, 2014

Medicare assignment

May accept Medicare assignment

Group practices

Family First Chiropractic L.L.CGroup PAC ID 6709984024, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Bachelor of Science

State licenses

Practice roles

Locations

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

• Family First Chiropractic L.L.C

  • Chiropractor
  • Omaha, NE
  • NPI 1497975775
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1440979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440979200000",
    "number": "1619344256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2548 S DALTON ST",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672101909",
            "telephone_number": "316-214-0720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2548 S DALTON ST",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672101909",
            "telephone_number": "316-214-0720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMPLE",
        "first_name": "JEREMIAH",
        "middle_name": "FREDERICK",
        "name_prefix": "Dr.",
        "credential": "D.C., B.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-08-31",
        "last_updated": "2015-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NE",
            "license": "1856",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEBRASKA CHIROPRACTIC LICENSE NUMBER",
            "identifier": "1856",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Julie Marie Samaniego, MS, LCMFT
• Samantha Rose Counseling
• Samantha Runnion, Lscsw, LLC
• Samantha Smith Lscsw RPT
• Mary Sambou
• Nellie Nicole Sample, CPHT
• Sams West Inc
• Sams West Inc
• Marquez Jamar Sams, DMD
• Philippe Samson, MD

• Chiropractor in Wichita, KS
• Providers in Wichita, KS by specialty
• Chiropractor in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2015; 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.