Active NPI
Jibu Williams, D.C.
- Chiropractor
- Boca Raton, FL
National Provider Identifier
1881016202
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- CH10946
- Practice address
- 1499 W Yamato Rd
Boca Raton, FL 33431 - Phone
- (561) 208-5928
- NPI assigned
- Jan 21, 2014
- Reactivated
- Apr 12, 2018
- 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 | CH10946 | FL | Primary |
Addresses
Primary practice location
1499 W Yamato Rd
Boca Raton, FL 33431
Mailing address
1499 W Yamato Rd
Boca Raton, FL 33431-4435
Phone (612) 085-9285
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 |
|---|---|---|---|
| CH10946 | FL | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1390262400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1531440000000",
"number": "1881016202",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1499 W YAMATO RD",
"city": "BOCA RATON",
"state": "FL",
"postal_code": "334314435",
"telephone_number": "612-085-9285"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1499 W YAMATO RD",
"city": "BOCA RATON",
"state": "FL",
"postal_code": "33431",
"telephone_number": "561-208-5928"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIAMS",
"first_name": "JIBU",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-01-21",
"last_updated": "2018-07-13",
"deactivation_date": "2018-02-20",
"reactivation_date": "2018-04-12",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "FL",
"license": "CH10946",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boca Raton, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.