Active NPI
Jerod T Dawson, DC
- Chiropractor
- Loveland, CO
National Provider Identifier
1861663346
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 6194
- Practice address
- 1907 Boise Ave
Suite 1
Loveland, CO 80538-5016 - Phone
- (907) 663-2200
- Fax
- (907) 663-2201
- NPI assigned
- Mar 12, 2008
- 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 | 6194 | CO | Primary |
Addresses
Primary practice location
1907 Boise Ave
Suite 1
Loveland, CO 80538-5016
Mailing address
1907 Boise Ave
Suite 1
Loveland, CO 80538-5016
Phone (907) 663-2200
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| CO400062 | Other | CO | MEDICARE INDIVIDUAL PTAN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CO
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20080711000261 | CO | Practitioner - Chiropractic | 6204908916 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6194 | CO | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1205280000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1361923200000",
"number": "1861663346",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1907 BOISE AVE",
"address_2": "SUITE 1",
"city": "LOVELAND",
"state": "CO",
"postal_code": "805385016",
"telephone_number": "907-663-2200",
"fax_number": "907-663-2201"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1907 BOISE AVE",
"address_2": "SUITE 1",
"city": "LOVELAND",
"state": "CO",
"postal_code": "805385016",
"telephone_number": "907-663-2200",
"fax_number": "907-663-2201"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAWSON",
"first_name": "JEROD",
"middle_name": "T",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-03-12",
"last_updated": "2013-02-27",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "CO",
"license": "6194",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE INDIVIDUAL PTAN",
"identifier": "CO400062",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Loveland, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.