Active NPI
Jacob WT Harris, D.C.
- Chiropractor
- Burlington, WA
National Provider Identifier
1942512058
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- CH 60151328
- Practice address
- 417 Pease Rd
Burlington, WA 98233-3113 - Phone
- (360) 755-3042
- Fax
- (360) 539-8648
- NPI assigned
- Jul 6, 2010
- Last updated
- May 9, 2017
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | CH 60151328 | WA | Primary |
Addresses
Primary practice location
417 Pease Rd
Burlington, WA 98233-3113
Mailing address
417 Pease Rd
Burlington, WA 98233-3113
Phone (360) 755-3042
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100917000433 | WA | Practitioner - Chiropractic | 4880719525 | Practice locations: Burlington, WA |
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Palmer College Chiropractic - West Sunnyvale, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
417 Pease Rd
Burlington, WA 98233-3113
Phone (360) 755-3042
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CH 60151328 | WA | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1278374400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1494288000000",
"number": "1942512058",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "417 PEASE RD",
"city": "BURLINGTON",
"state": "WA",
"postal_code": "982333113",
"telephone_number": "360-755-3042"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "417 PEASE RD",
"city": "BURLINGTON",
"state": "WA",
"postal_code": "982333113",
"telephone_number": "360-755-3042",
"fax_number": "360-539-8648"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARRIS",
"first_name": "JACOB",
"middle_name": "WT",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-07-06",
"last_updated": "2017-05-09",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "WA",
"license": "CH 60151328",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Burlington, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2017; 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.