Active NPI
Jason P Beck, D.C.
- Chiropractor
- San Rafael, CA
National Provider Identifier
1700813540
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- DC28208
- Practice address
- 1050 Northgate Dr
Ste 12
San Rafael, CA 94903-2544 - Phone
- (707) 766-6363
- NPI assigned
- Jun 27, 2006
- 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 | DC28208 | CA | Primary |
Addresses
Primary practice location
1050 Northgate Dr
Ste 12
San Rafael, CA 94903-2544
Mailing address
1050 Northgate Dr
Ste 12
San Rafael, CA 94903-2544
Phone (707) 766-6363
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050810000634 | CA | Practitioner - Chiropractic | 3274562277 | Practice locations: San Rafael, CA |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 28208 | CA | MD | Psychologist |
| DC28208 | CA | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Beck Chiropractic Professional Corporation | Chiropractor | Past | Accepting new patients |
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.
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- Petaluma, CA
- NPI 1205072782
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151366400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1590537600000",
"number": "1700813540",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1050 NORTHGATE DR",
"address_2": "STE 12",
"city": "SAN RAFAEL",
"state": "CA",
"postal_code": "949032544",
"telephone_number": "707-766-6363"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1050 NORTHGATE DR",
"address_2": "STE 12",
"city": "SAN RAFAEL",
"state": "CA",
"postal_code": "949032544",
"telephone_number": "707-766-6363"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BECK",
"first_name": "JASON",
"middle_name": "P",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-06-27",
"last_updated": "2020-05-27",
"certification_date": "2020-05-27",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "CA",
"license": "DC28208",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Rafael, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.