Individual provider Active NPI

Jeffrey Dale Landis, DC, FIAMA

  • Chiropractor
  • Thornton, CO
National Provider Identifier
1740368729
Registry record updated Nov 9, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3556 Issued in CO
Practice address
10351 Grant St Unit 1
Thornton, CO 80229-2032
Phone
(303) 252-4580
Fax
(303) 252-4579
NPI assigned
Nov 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3556 CO Primary

Addresses

Primary practice location

10351 Grant St Unit 1
Thornton, CO 80229-2032

Mailing address

10351 Grant St Unit 1
Thornton, CO 80229-2032
Phone (303) 252-4580

Other practice location 1

1484 W 104th Ave
Northglenn, CO 80234-3712
Phone (303) 252-4580

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
3556COMDProfessional Counselor

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1510185600000",
    "number": "1740368729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10351 GRANT ST UNIT 1",
            "city": "THORNTON",
            "state": "CO",
            "postal_code": "802292032",
            "telephone_number": "303-252-4580",
            "fax_number": "303-252-4579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10351 GRANT ST UNIT 1",
            "city": "THORNTON",
            "state": "CO",
            "postal_code": "802292032",
            "telephone_number": "303-252-4580",
            "fax_number": "303-252-4579"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1484 W 104th Ave",
            "address_purpose": "LOCATION",
            "city": "Northglenn",
            "state": "CO",
            "postal_code": "802343712",
            "country_code": "US",
            "telephone_number": "303-252-4580",
            "fax_number": "303-252-4579",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LANDIS",
        "first_name": "JEFFREY",
        "middle_name": "DALE",
        "name_prefix": "Dr.",
        "credential": "DC, FIAMA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2017-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CO",
            "license": "3556",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Thornton, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.