Individual provider Active NPI

Jeffery Ronald Patt, D.C.

  • Chiropractor
  • Gladwin, MI
National Provider Identifier
1639394109
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
JP003048 Issued in MI
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, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
JP003048MIMDChiropractor

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.

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.

Verify at the official NPI Registry.