Individual provider Active NPI

Jeffrey Conner, D. C.

  • Chiropractor
  • Glendale, AZ
National Provider Identifier
1922035294
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5679 Issued in AZ
Practice address
6615 W Happy Valley Rd
Ste B105
Glendale, AZ 85310-2608
Phone
(623) 572-9820
Fax
(623) 572-9830
NPI assigned
Jun 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 5679 AZ Primary

Addresses

Primary practice location

6615 W Happy Valley Rd
Ste B105
Glendale, AZ 85310-2608

Mailing address

6615 W Happy Valley Rd
Ste B105
Glendale, AZ 85310-2608
Phone (623) 572-9820

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051018000011 AZ Practitioner - Chiropractic 6103842398 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

6615 W Happy Valley Rd
Suite B105
Glendale, AZ 85310-2608
Phone (623) 572-9820

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Chiropractic Joint LLC Chiropractor Past Accepting new patients
Nelson Life Centers Chiropractor Past Accepting new patients

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1151280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1922035294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6615 W HAPPY VALLEY RD",
            "address_2": "STE B105",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853102608",
            "telephone_number": "623-572-9820",
            "fax_number": "623-572-9830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6615 W HAPPY VALLEY RD",
            "address_2": "STE B105",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853102608",
            "telephone_number": "623-572-9820",
            "fax_number": "623-572-9830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONNER",
        "first_name": "JEFFREY",
        "name_prefix": "Mr.",
        "credential": "D. C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AZ",
            "license": "5679",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.