Individual provider Active NPI

Marcus Anthony Jahna, D.C.

  • Chiropractor
  • Lake Wales, FL
National Provider Identifier
1841583929
Registry record updated Dec 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH10304 Issued in FL
Practice address
23857 Hwy 27
Lake Wales, FL 33859-0000
Phone
(863) 949-4815
Fax
(863) 949-4826
NPI assigned
May 23, 2011
Last updated
Dec 22, 2014By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 22, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH10304 FL Primary

Addresses

Primary practice location

23857 Hwy 27
Lake Wales, FL 33859-0000

Mailing address

23857 Hwy 27
Lake Wales, FL 33859-7811
Phone (863) 949-4815

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

LicenseStateTypeSpecialty
CH10304FLMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Chirocare Solutions LLC Chiropractor PastSince Jan 1, 2017 Accepting new patients
Smith Business Trust, Cto Chiropractor Past Accepting new patients

Organizations & group practices 2

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": "1306108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1419206400000",
    "number": "1841583929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23857 HWY 27",
            "city": "LAKE WALES",
            "state": "FL",
            "postal_code": "338597811",
            "telephone_number": "863-949-4815",
            "fax_number": "863-949-4826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23857 HWY 27",
            "city": "LAKE WALES",
            "state": "FL",
            "postal_code": "338590000",
            "telephone_number": "863-949-4815",
            "fax_number": "863-949-4826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAHNA",
        "first_name": "MARCUS",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-05-23",
        "last_updated": "2014-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH10304",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Wales, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2014; 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.