Jared Elijah Allison, D.C.
Individual provider Active NPI Chiropractor · Derry, PA
NPI 1902331879 · NPPES record last updated Apr 27, 2017
Key facts
- NPI
- 1902331879
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- DC011255 (PA)
- Practice address
- 310 S Chestnut St
Derry, PA 15627-1220 - Phone
- (724) 694-9700
- NPI assigned
- Apr 27, 2017
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170622001055 | PA | Practitioner - Chiropractic | 6901174531 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DC011255 | PA | MD | Chiropractor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | DC011255 | PA | Yes |
Addresses
Primary practice location
310 S Chestnut St
Derry, PA 15627-1220
Mailing address
296 Squibbs Rd
Blairsville, PA 15717-4102
Other providers in Derry, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 27, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.