Individual provider Active NPI

Jon Robert Alter, D,C.

  • Chiropractor
  • Fort Wayne, IN
National Provider Identifier
1689865115
Registry record updated Nov 21, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
08000142A Issued in IN
Practice address
4222 Hobson CT
Fort Wayne, IN 46815-8648
Phone
(260) 485-3146
Fax
(260) 486-5278
NPI assigned
Aug 8, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 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 08000142A IN Primary

Addresses

Primary practice location

4222 Hobson CT
Fort Wayne, IN 46815-8648

Mailing address

4222 Hobson CT
Fort Wayne, IN 46815-8648
Phone (260) 485-3146

Other identifiers 2

IdentifierTypeStateIssuer
1760527709OtherINGROUP NUMBER
100081870BMedicaidIN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120124000828 IN Practitioner - Chiropractic 9830120286 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 1980
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

4222 Hobson CT
Fort Wayne, IN 46815-8648
Phone (260) 485-3146

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
08000142AINMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Chiropractic Health Services, P.C. Chiropractor CurrentSince Jan 24, 2012 Accepting new patients

Locations

4222 Hobson Ct
Fort Wayne, IN 46815
Phone (219) 485-3146

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": "1186531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1195603200000",
    "number": "1689865115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4222 HOBSON CT",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468158648",
            "telephone_number": "260-485-3146",
            "fax_number": "260-486-5278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4222 HOBSON CT",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468158648",
            "telephone_number": "260-485-3146",
            "fax_number": "260-486-5278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALTER",
        "first_name": "JON",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "D,C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-08",
        "last_updated": "2007-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IN",
            "license": "08000142A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NUMBER",
            "identifier": "1760527709",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100081870B",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 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.