Jeff Crippen
Individual provider Active NPI Nutrition Chiropractor · Saint Jo, TX
NPI 1710242060 · NPPES record last updated Jul 11, 2012
Key facts
- NPI
- 1710242060
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nutrition Chiropractor 111NN1001X
- License
- 11978 (TX)
- Practice address
- 1400 Camp Letoli Rd
Saint Jo, TX 76265-6317 - Phone
- (214) 755-7513
- NPI assigned
- Jul 11, 2012
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20231222000003 | TX | Practitioner - Chiropractic | 5294184016 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11978 | TX | MD | Addiction (Substance Use Disorder) Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| JFC Enterprises LLC | Current |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nutrition Chiropractor | 111NN1001X | 11978 | TX | Yes |
Addresses
Primary practice location
1400 Camp Letoli Rd
Saint Jo, TX 76265-6317
Mailing address
1400 Camp Letoli Rd
Saint Jo, TX 76265-6317
Other providers in Saint Jo, TX
- Maribeth Baxter
- City of Saint Jo
- Samantha Elaine Harris
- JFC Enterprises LLC
- Debra Kay Maas
- Nocona Hospital District
- Nocona Hospital District
All providers in Saint Jo, TX · Nutrition Chiropractor in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 11, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.