Active NPI
John Robert Deboard, DC
- Chiropractor
- Ceres, CA
National Provider Identifier
1700979374
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 10774
- Practice address
- 2943 4TH St
Ceres, CA 95307-3222 - Phone
- (209) 537-5068
- Fax
- (209) 537-9747
- NPI assigned
- Oct 2, 2006
- Sex
- Male
- Sole proprietor
- No
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 | 10774 | CA | Primary |
Addresses
Primary practice location
2943 4TH St
Ceres, CA 95307-3222
Mailing address
2943 4TH St
Ceres, CA 95307-3222
Phone (209) 537-5068
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 10774 | Other | CA | BD CHIRO EXAMINERS LIC |
| DC0107740 | Medicaid | CA |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 10774 | CA | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159747200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1700979374",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2943 4TH ST",
"city": "CERES",
"state": "CA",
"postal_code": "953073222",
"telephone_number": "209-537-5068",
"fax_number": "209-537-9747"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2943 4TH ST",
"city": "CERES",
"state": "CA",
"postal_code": "953073222",
"telephone_number": "209-537-5068",
"fax_number": "209-537-9747"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEBOARD",
"first_name": "JOHN",
"middle_name": "ROBERT",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-02",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "CA",
"license": "10774",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BD CHIRO EXAMINERS LIC",
"identifier": "10774",
"state": "CA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "DC0107740",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Ceres, CA
- Ebony Shealease Davis
- Janay Davis
- Michael G Davis, P.T.
- Robert J De Stefano, CAS
- Deboard & Govett, Doctors of Chiropractic, a Professional Corporation.
- Del Valle Therapy Services, Licensed Clinical Social Worker, a Professional Corporation
- Adriana Del Valle, NP
- Ashley S Del Valle, MSW, LCSW
- Diane Cox Delcarlo
- Jasbir K Dhami, RNC
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.