Individual provider Active NPI

Jason R. Haycock, DC

  • Chiropractor
  • Lyman, WY
National Provider Identifier
1760668362
Registry record updated Jan 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
611 Issued in WY
Practice address
225 W Owen St.
Lyman, WY 82937
Phone
(307) 787-6400
NPI assigned
Jan 14, 2008
Last updated
Jan 29, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 29, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 611 WY Primary

Addresses

Primary practice location

225 W Owen St.
Lyman, WY 82937

Mailing address

PO Box 1194
Lyman, WY 82937-1194
Phone (307) 787-6400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120402000573 WY Practitioner - Chiropractic 7810970605 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

109 S Main St
Suite a
Lyman, WY 82937-1194
Phone (307) 787-6400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Back to Health Chiropractic Inc Chiropractor CurrentSince Jun 1, 2003 Accepting new patients

Locations

109 S Main St
Ste A
Lyman, WY 82937
Phone (307) 787-6400

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1200268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1201564800000",
    "number": "1760668362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1194",
            "city": "LYMAN",
            "state": "WY",
            "postal_code": "829371194",
            "telephone_number": "307-787-6400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 W OWEN ST.",
            "city": "LYMAN",
            "state": "WY",
            "postal_code": "82937",
            "telephone_number": "307-787-6400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAYCOCK",
        "first_name": "JASON",
        "middle_name": "R.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-01-14",
        "last_updated": "2008-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WY",
            "license": "611",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lyman, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.