Individual provider Active NPI

Joseph Gerard Hofferth, D.C.

  • Chiropractor
  • Hammond, IN
National Provider Identifier
1629101902
Registry record updated Jul 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
08001623 Issued in IN
Practice address
1828 165TH St Ste a
Hammond, IN 46320-2823
Phone
(219) 763-8112
Fax
(219) 844-9006
NPI assigned
Mar 14, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 08001623 IN Primary

Addresses

Primary practice location

1828 165TH St Ste a
Hammond, IN 46320-2823

Mailing address

PO Box 1430
Portage, IN 46368-9230
Phone (219) 763-8112

Other identifiers 2

IdentifierTypeStateIssuer
300046583MedicaidIN
191360058OtherINMEDICARE PTAN

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
08001623INMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Northshore Health Centers Inc Current Accepting new patients
Northshore Health Centers, Inc. Chiropractor CurrentSince Jan 6, 2021 Accepting new patients
Northshore Health Centers, Inc. CurrentSince Jan 6, 2021 Accepting new patients

Locations

1828 165th St
Ste A
Hammond, IN 46320

6050 Sterling Creek Rd
Portage, IN 46368
Phone (219) 212-0188

Interoperability endpoints

  • Direct secure messaging: joe.hofferth.p1@direct.northshorehealth.nextgenshare.com

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": "1173830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626739200000",
    "number": "1629101902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1430",
            "city": "PORTAGE",
            "state": "IN",
            "postal_code": "463689230",
            "telephone_number": "219-763-8112",
            "fax_number": "219-764-5333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1828 165TH ST STE A",
            "city": "HAMMOND",
            "state": "IN",
            "postal_code": "463202823",
            "telephone_number": "219-763-8112",
            "fax_number": "219-844-9006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOFFERTH",
        "first_name": "JOSEPH",
        "middle_name": "GERARD",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-14",
        "last_updated": "2021-07-20",
        "certification_date": "2021-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IN",
            "license": "08001623",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300046583",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "191360058",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hammond, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2021; 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.