Active NPI
Jason M. Green, D.C.
- Chiropractor
- Galena, IL
National Provider Identifier
1811275795
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 038.011965
- Practice address
- 400 Broadway St
Galena, IL 61036-1902 - Phone
- (815) 777-0042
- NPI assigned
- Jul 26, 2011
- 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 | 038.011965 | IL | Primary |
Addresses
Primary practice location
400 Broadway St
Galena, IL 61036-1902
Mailing address
1736 Hwy 80
Cuba City, WI 53807-9708
Phone (563) 209-8583
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 |
|---|---|---|---|
| 038.011965 | IL | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Galena Chiropractic Center PC | Chiropractor | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Chiropractor
- Galena, IL
- NPI 1275524241
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1311638400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1311638400000",
"number": "1811275795",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1736 HWY 80",
"city": "CUBA CITY",
"state": "WI",
"postal_code": "538079708",
"telephone_number": "563-209-8583"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "400 BROADWAY ST",
"city": "GALENA",
"state": "IL",
"postal_code": "610361902",
"telephone_number": "815-777-0042"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREEN",
"first_name": "JASON",
"middle_name": "M.",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-07-26",
"last_updated": "2011-07-26",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "IL",
"license": "038.011965",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Galena, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.