Active NPI
Jeffery Ronald Patt, D.C.
- Chiropractor
- Gladwin, MI
National Provider Identifier
1639394109
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- JP003048
- Practice address
- 1139 E Cedar Ave
Pob367
Gladwin, MI 48624-7003 - Phone
- (989) 426-8461
- Fax
- (989) 426-2121
- NPI assigned
- Apr 17, 2007
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | JP003048 | MI | Primary |
Addresses
Primary practice location
1139 E Cedar Ave
Pob367
Gladwin, MI 48624-7003
Mailing address
1139 E Cedar Ave
Pob367
Gladwin, MI 48624-7003
Phone (989) 426-8461
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
| License | State | Type | Specialty |
|---|---|---|---|
| JP003048 | MI | MD | Chiropractor |
Organizations & group practices 1
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.
-
- Chiropractor
- Gladwin, MI
- NPI 1497970990
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176768000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1639394109",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1139 E CEDAR AVE",
"address_2": "POB367",
"city": "GLADWIN",
"state": "MI",
"postal_code": "486247003",
"telephone_number": "989-426-8461",
"fax_number": "989-426-2121"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1139 E CEDAR AVE",
"address_2": "POB367",
"city": "GLADWIN",
"state": "MI",
"postal_code": "486247003",
"telephone_number": "989-426-8461",
"fax_number": "989-426-2121"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PATT",
"first_name": "JEFFERY",
"middle_name": "RONALD",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-04-17",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "MI",
"license": "JP003048",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Gladwin, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.