Individual provider Active NPI

Jeffrey Thomas Hanes, DC

  • Chiropractor
  • Chillicothe, OH
National Provider Identifier
1629062484
Registry record updated Dec 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2634 Issued in OH
Practice address
6 Medical Dr
Chillicothe, OH 45601-8603
Phone
(740) 773-9355
Fax
(740) 772-6483
NPI assigned
Sep 8, 2005
Last updated
Dec 26, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 26, 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 2634 OH Primary

Addresses

Primary practice location

6 Medical Dr
Chillicothe, OH 45601-8603

Mailing address

1 Health Dr
Chillicothe, OH 45601-8604
Phone (740) 772-5957

Other identifiers 2

IdentifierTypeStateIssuer
2060693MedicaidOH
000000256388OtherANTHEM PIN NUMBER

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061003000105 OH Practitioner - Chiropractic 3577587021 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 1998
Medicare assignment
May accept Medicare assignment
Group practices
Pure Health Management IncGroup PAC ID 9234479163, 3 clinicians

Practice addresses (Care Compare)

6 Medical Dr
Chillicothe, OH 45601-8603
Phone (740) 773-9355

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2634OHMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Pure Health Management Inc. Chiropractor CurrentSince Dec 26, 2018 Accepting new patients
Natural Medicine,LLC Chiropractor PastSince Dec 26, 2015 Accepting new patients
Scioto Valley Rehab,LLC PastSince Jan 23, 2006 Accepting new patients

Locations

6 Medical Dr
Chillicothe, OH 45601
Phone (740) 773-9355

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": "1126137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545782400000",
    "number": "1629062484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 HEALTH DR",
            "city": "CHILLICOTHE",
            "state": "OH",
            "postal_code": "456018604",
            "telephone_number": "740-772-5957",
            "fax_number": "740-772-6483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 MEDICAL DR",
            "city": "CHILLICOTHE",
            "state": "OH",
            "postal_code": "456018603",
            "telephone_number": "740-773-9355",
            "fax_number": "740-772-6483"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANES",
        "first_name": "JEFFREY",
        "middle_name": "THOMAS",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-08",
        "last_updated": "2018-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OH",
            "license": "2634",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2060693",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PIN NUMBER",
            "identifier": "000000256388",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chillicothe, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 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.