Active NPI
Jerome Randall Kershaw, DC
- Chiropractor
- Pasadena, CA
National Provider Identifier
1730191834
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- DC13573
- Practice address
- 2700 E Foothill Blvd
Suite 202
Pasadena, CA 91107 - Phone
- (626) 449-2000
- Fax
- (626) 449-2043
- NPI assigned
- Aug 13, 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 | DC13573 | CA | Primary |
Addresses
Primary practice location
2700 E Foothill Blvd
Suite 202
Pasadena, CA 91107
Mailing address
2700 E Foothill Blvd
Suite 202
Pasadena, CA 91107
Phone (626) 449-2000
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 |
|---|---|---|---|
| 13573 | CA | MD | Addiction (Substance Use Disorder) Counselor |
| DC13573 | CA | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155427200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1730191834",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2700 E FOOTHILL BLVD",
"address_2": "SUITE 202",
"city": "PASADENA",
"state": "CA",
"postal_code": "91107",
"telephone_number": "626-449-2000",
"fax_number": "626-449-2043"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2700 E FOOTHILL BLVD",
"address_2": "SUITE 202",
"city": "PASADENA",
"state": "CA",
"postal_code": "91107",
"telephone_number": "626-449-2000",
"fax_number": "626-449-2043"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KERSHAW",
"first_name": "JEROME",
"middle_name": "RANDALL",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-13",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "CA",
"license": "DC13573",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pasadena, CA
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.