Dr J L McCallister

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

0514530 Issued in CA

Legal business name

DR J L MCCALLISTER

Practice address

60 Fenton St Ste 4
Livermore, CA 94550-4196

Phone

(925) 449-4884

Fax

(925) 449-5596

NPI assigned

Mar 7, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Jimmie Lee McCallister, DCNPI 1114945763

Title

Owner

Phone

(925) 449-4884

Specialties & licenses 1

Addresses

Other names 1

• Livermore Chiropractic Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 1

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

• Jimmie McCallister, DC,QME

  • Chiropractor
  • Livermore, CA
  • NPI 1114945763
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728777600000",
    "number": "1962532762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 FENTON ST STE 4",
            "city": "LIVERMORE",
            "state": "CA",
            "postal_code": "945504196",
            "telephone_number": "925-449-4884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 FENTON ST STE 4",
            "city": "LIVERMORE",
            "state": "CA",
            "postal_code": "945504196",
            "telephone_number": "925-449-4884",
            "fax_number": "925-449-5596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR J L MCCALLISTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-07",
        "last_updated": "2024-10-13",
        "certification_date": "2024-10-13",
        "status": "A",
        "authorized_official_last_name": "MCCALLISTER",
        "authorized_official_first_name": "JIMMIE",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "925-449-4884",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "0514530",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Livermore Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Chiropractor in Livermore, CA
• Providers in Livermore, CA by specialty
• Chiropractor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2024; 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.