Individual provider Active NPI

Jeffrey Quentin Harper, DC

  • Chiropractor
  • Canyon Lake, TX
National Provider Identifier
1649543455
Registry record updated Feb 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
11974 Issued in TX
Practice address
1742 FM 2673
Canyon Lake, TX 78133
Phone
(830) 964-3032
Fax
(830) 964-4460
NPI assigned
Feb 10, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 10, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 11974 TX Primary

Addresses

Primary practice location

1742 FM 2673
Canyon Lake, TX 78133

Mailing address

1742 FM 2673
Canyon Lake, TX 78133
Phone (830) 964-3032

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120821000424 TX Practitioner - Chiropractic 3072760453 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College - West, 2011
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1742 FM
2673 Suite 1
Canyon Lake, TX 78133-4744
Phone (830) 964-3032

1742 FM 2673
Suite 1
Canyon Lake, TX 78133-4743

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11974TXMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Hill Country Chiropractic Clinic Chiropractor PastSince May 7, 2012 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1328832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328832000000",
    "number": "1649543455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1742 FM 2673",
            "city": "CANYON LAKE",
            "state": "TX",
            "postal_code": "78133",
            "telephone_number": "830-964-3032",
            "fax_number": "830-964-4460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1742 FM 2673",
            "city": "CANYON LAKE",
            "state": "TX",
            "postal_code": "78133",
            "telephone_number": "830-964-3032",
            "fax_number": "830-964-4460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARPER",
        "first_name": "JEFFREY",
        "middle_name": "QUENTIN",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-02-10",
        "last_updated": "2012-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "11974",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canyon Lake, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2012; 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.