Individual provider Active NPI

Jake Hunter Doster, D.C.

  • Chiropractor
  • Jackson, TN
National Provider Identifier
1962754325
Registry record updated Oct 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2630 Issued in TN
Practice address
3566 Highway 45 N
Jackson, TN 38305-7890
Phone
(731) 664-8000
Fax
(731) 664-8100
NPI assigned
Oct 10, 2012
Last updated
Oct 10, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 10, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2630 TN Primary

Addresses

Primary practice location

3566 Highway 45 N
Jackson, TN 38305-7890

Mailing address

3566 Highway 45 N
Jackson, TN 38305-7890
Phone (731) 664-8000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130424000852 TN Practitioner - Chiropractic 0648416388 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Steets CorporationGroup PAC ID 2567514896, 2 clinicians

Practice addresses (Care Compare)

3566 N Highland Ave
Suite a
Jackson, TN 38305-7890
Phone (731) 664-8000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2630TNMDOccupational Therapist

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1349827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349827200000",
    "number": "1962754325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3566 HIGHWAY 45 N",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383057890",
            "telephone_number": "731-664-8000",
            "fax_number": "731-664-8100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3566 HIGHWAY 45 N",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383057890",
            "telephone_number": "731-664-8000",
            "fax_number": "731-664-8100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOSTER",
        "first_name": "JAKE",
        "middle_name": "HUNTER",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-10-10",
        "last_updated": "2012-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TN",
            "license": "2630",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2012; 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.