Individual provider Active NPI

Jon Eirik Holm Johansen, DC

  • Chiropractor
  • Loveland, CO
National Provider Identifier
1689713455
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4891 Issued in CO
Practice address
2180 W Eisenhower Blvd
Loveland, CO 80537-3146
Phone
(970) 203-0597
Fax
(970) 203-0654
NPI assigned
Feb 6, 2007
Sex
Male
Sole proprietor
No

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 4891 CO Primary

Addresses

Primary practice location

2180 W Eisenhower Blvd
Loveland, CO 80537-3146

Mailing address

2180 W Eisenhower Blvd
Loveland, CO 80537-3146
Phone (970) 203-0597

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051222000643 CO Practitioner - Chiropractic 5799707360 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Northwestern College of Chiropractic, 1999
Medicare assignment
May accept Medicare assignment
Group practices
Thompson Valley Chiropractic PCGroup PAC ID 2365419447, 2 clinicians

Practice addresses (Care Compare)

2180 W Eisenhower Blvd
Loveland, CO 80537-3146
Phone (970) 203-0597

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4891COMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Thompson Valley Chiropractic PC Chiropractor CurrentSince May 15, 2000 Accepting new patients

Locations

2180 W Eisenhower Blvd
Loveland, CO 80537
Phone (970) 203-0597

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1689713455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2180 W EISENHOWER BLVD",
            "city": "LOVELAND",
            "state": "CO",
            "postal_code": "805373146",
            "telephone_number": "970-203-0597",
            "fax_number": "970-203-0654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2180 W EISENHOWER BLVD",
            "city": "LOVELAND",
            "state": "CO",
            "postal_code": "805373146",
            "telephone_number": "970-203-0597",
            "fax_number": "970-203-0654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLM JOHANSEN",
        "first_name": "JON EIRIK",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CO",
            "license": "4891",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Loveland, CO

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.
  • 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.