Individual provider Active NPI

Jason A. Degenhardt, D.C.

  • Chiropractor
  • Harker Heights, TX
National Provider Identifier
1801810361
Registry record updated Oct 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
9654 Issued in TX
Practice address
560 E Central Texas Expy Ste 102
Harker Heights, TX 76548-5625
Phone
(254) 698-1600
Fax
(254) 698-1605
NPI assigned
Jul 27, 2006
Last updated
Oct 20, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 9654 TX Primary

Addresses

Primary practice location

560 E Central Texas Expy Ste 102
Harker Heights, TX 76548-5625

Mailing address

560 E Central Texas Expy Ste 102
Harker Heights, TX 76548-5625
Phone (254) 698-1600

Other identifiers 1

IdentifierTypeStateIssuer
8M6299OtherTXBLUE CROSS BLUE SHIELD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040317001441 TX Practitioner - Chiropractic 7719877349 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Corrective Chiropractic P.a.Group PAC ID 6002095502, 4 clinicians

Practice addresses (Care Compare)

560 E Central Texas Expy
Suite 102
Harker Heights, TX 76548-5625
Phone (254) 698-1600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9654TXMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Corrective Chiropractic P.a. Chiropractor CurrentSince Dec 30, 2010 Accepting new patients
Corrective Chiropractic, P.a. Chiropractor CurrentSince Jan 12, 2009 Accepting new patients
Isdale Chiropractic Clinic Chiropractor PastSince Dec 9, 2015 Accepting new patients

Locations

560 E Central Texas Expy
Harker Hts, TX 76548
Phone (254) 698-1600

560 E Central Texas Expy
Ste 102
Harker Hts, TX 76548
Phone (254) 677-6555

716 Indian Trl
Ste 120
Harker Hts, TX 76548
Phone (254) 300-8339

Organizations & group practices 3

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": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603152000000",
    "number": "1801810361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "560 E CENTRAL TEXAS EXPY STE 102",
            "city": "HARKER HEIGHTS",
            "state": "TX",
            "postal_code": "765485625",
            "telephone_number": "254-698-1600",
            "fax_number": "254-698-1605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "560 E CENTRAL TEXAS EXPY STE 102",
            "city": "HARKER HEIGHTS",
            "state": "TX",
            "postal_code": "765485625",
            "telephone_number": "254-698-1600",
            "fax_number": "254-698-1605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEGENHARDT",
        "first_name": "JASON",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2020-10-20",
        "certification_date": "2020-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "9654",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "8M6299",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Harker Heights, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2020; 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.