Jessica Rae Holland, DC

Individual provider Active NPI Chiropractor · Lyndora, PA

NPI 1821641283 · NPPES record last updated Jul 23, 2022

Key facts

NPI
1821641283
Entity type
Individual (NPI type 1)
Primary specialty
Chiropractor 111N00000X
License
DC011693 (PA)
Practice address
6 Chesapeake St Ste 205
Lyndora, PA 16045-1150
Phone
(724) 822-1828
NPI assigned
Jul 24, 2019
Sex
Female
Sole proprietor
Yes

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.

Medicare Care Compare profile

Specialty
Chiropractic
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
A Butler Chiropractic, PLLC (2 clinicians)

Practice addresses (Care Compare)

6 Chesapeake St
Suite 205
Lyndora, PA 16045-1150
Phone (724) 290-2276

Medicare participation

Medicare fee-for-service enrollment
Enrolled in PA

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20220905000466 PA Practitioner - Chiropractic 6204210537 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
038.013390ILMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
A. Butler Chiropractic PLLC Chiropractor Current
since Aug 1, 2022
Accepting new patients

Locations

6 Chesapeake St
Ste 205
Lyndora, PA 16045
Phone (724) 282-0404

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor
Group: 193400000X SINGLE SPECIALTY GROUP
111N00000X 038.013390 IL
Chiropractor
Group: 193400000X SINGLE SPECIALTY GROUP
111N00000X DC011693 PA Yes

Addresses

Primary practice location

6 Chesapeake St Ste 205
Lyndora, PA 16045-1150

Mailing address

6 Chesapeake St Ste 205
Lyndora, PA 16045-1150
Phone (172) 482-2182

Electronic endpoints

TypeEndpointUseAffiliation
Direct Messaging Address drjess@abutlerchiro.com

Other providers in Lyndora, PA

All providers in Lyndora, PA · Chiropractor in Pennsylvania

Sources for this page

Verify at the official NPI Registry.