Active NPI
Jack Kaplan
- Driver
- Peoria, AZ
National Provider Identifier
1972703692
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Driver
- License
- D04449259
- Practice address
- 29156 N 122ND Dr
Peoria, AZ 85383-2423 - Phone
- (623) 512-0625
- NPI assigned
- Jul 20, 2007
- 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 |
|---|---|---|---|---|
| Driver | 172A00000X | D04449259 | AZ | Primary |
Addresses
Primary practice location
29156 N 122ND Dr
Peoria, AZ 85383-2423
Mailing address
29156 N 122ND Dr
Peoria, AZ 85383-2423
Phone (623) 512-0625
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D04449259 | AZ | MD | Driver |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1184889600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1184889600000",
"number": "1972703692",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "29156 N 122ND DR",
"city": "PEORIA",
"state": "AZ",
"postal_code": "853832423",
"telephone_number": "623-512-0625"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "29156 N 122ND DR",
"city": "PEORIA",
"state": "AZ",
"postal_code": "853832423",
"telephone_number": "623-512-0625"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KAPLAN",
"first_name": "JACK",
"name_prefix": "Mr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-07-20",
"last_updated": "2007-07-20",
"status": "A"
},
"taxonomies": [
{
"code": "172A00000X",
"taxonomy_group": "",
"desc": "Driver",
"state": "AZ",
"license": "D04449259",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Peoria, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.