NPIMap

Organization Active NPI

Docjjr, LLC

  • Chiropractor
  • Omaha, NE
National Provider Identifier
1922467117
Registry record updated May 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1367 Issued in NE
Legal business name
DOCJJR, LLC
Practice address
11917 Pierce PLZ
Omaha, NE 68144-1648
Phone
(402) 778-1100
Fax
(402) 778-1200
NPI assigned
Feb 16, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 24, 2019

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

Authorized official

Name
Dr. Jeremiah Jon Rethwisch, DCNPI 1447264254
Title
President
Phone
(402) 980-6991

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 1367 NE Primary

Addresses

Primary practice location

11917 Pierce PLZ
Omaha, NE 68144-1648

Mailing address

18010 R PLZ Ste 104
Omaha, NE 68135-1923
Phone (402) 980-6991

Other names 1

  • Back & Body Wellness Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160713001100 NE Part B Supplier - Clinic/Group Practice 9436441383 Receives reassigned benefits from 2 practitioners
Practice locations: Omaha, NE

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

12010 Pacific St
Omaha, NE 68154
Phone (402) 778-1100

11917 Pierce Plz
Omaha, NE 68144
Phone (402) 778-1100

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1455580800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1558656000000",
    "number": "1922467117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18010 R PLZ STE 104",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681351923",
            "telephone_number": "402-980-6991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11917 PIERCE PLZ",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681441648",
            "telephone_number": "402-778-1100",
            "fax_number": "402-778-1200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOCJJR, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-16",
        "last_updated": "2019-05-24",
        "status": "A",
        "authorized_official_last_name": "RETHWISCH",
        "authorized_official_first_name": "JEREMIAH",
        "authorized_official_middle_name": "JON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "402-980-6991",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "NE",
            "license": "1367",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Back & Body Wellness",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Back & Body Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Omaha, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2019; 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.

Verify at the official NPI Registry.