Active NPI
John Ben Hassam, D.C. CHIROPRACTOR
- Chiropractor
- Gulfport, MS
National Provider Identifier
1902859176
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 1353
- Practice address
- 2045 E Pass Rd Ste B
Gulfport, MS 39507-3761 - Phone
- (228) 896-7574
- Fax
- (228) 896-7579
- NPI assigned
- May 18, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 038009480 | IL | |
| Chiropractor | 111N00000X | 1353 | MS | Primary |
Addresses
Primary practice location
2045 E Pass Rd Ste B
Gulfport, MS 39507-3761
Mailing address
2045 E Pass Rd Ste B
Gulfport, MS 39507-3761
Phone (228) 896-7574
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902859176 | Other | IL | NPI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MS
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1353 | MS | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Big River Chiropractic Horn Lake PLLC | Chiropractor | Current | Accepting new patients |
| Jernigan Chiropractic Clinic Inc | Chiropractor | Current | Accepting new patients |
| Align Chiropractic PC | Past | Accepting new patients |
Locations
2045 E Pass Rd
#B
Gulfport, MS 39507
Phone (228) 896-7574
Organizations & group practices 3
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.
-
- Multi-Specialty Clinic/Center
- Gulfport, MS
- NPI 1275701781
Chiropractor
-
- Chiropractor
- Horn Lake, MS
- NPI 1902615040
-
- Rehabilitation Chiropractor
- Ocean Springs, MS
- NPI 1649893892
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147910400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1687219200000",
"number": "1902859176",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2045 E PASS RD STE B",
"city": "GULFPORT",
"state": "MS",
"postal_code": "395073761",
"telephone_number": "228-896-7574",
"fax_number": "228-896-7579"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2045 E PASS RD STE B",
"city": "GULFPORT",
"state": "MS",
"postal_code": "395073761",
"telephone_number": "228-896-7574",
"fax_number": "228-896-7579"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HASSAM",
"first_name": "JOHN",
"middle_name": "BEN",
"name_prefix": "Dr.",
"credential": "D.C. CHIROPRACTOR",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-05-18",
"last_updated": "2023-06-20",
"certification_date": "2023-06-20",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "IL",
"license": "038009480",
"primary": false
},
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "MS",
"license": "1353",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NPI",
"identifier": "1902859176",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Gulfport, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2023; 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.