1164544136 NPI number — JASON C HELFRICH D.C.

Table of content: JASON C HELFRICH D.C. (NPI 1164544136)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1164544136 NPI number — JASON C HELFRICH D.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HELFRICH
Provider First Name:
JASON
Provider Middle Name:
C
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
D.C.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1164544136
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
13 S TEJON ST STE 206
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
COLORADO SPRINGS
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80903-1520
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
719-630-4936
Provider Business Mailing Address Fax Number:
719-635-0939

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
18025 CALLE AMBIENTE
Provider Second Line Business Practice Location Address:
STE 204
Provider Business Practice Location Address City Name:
RANCHO SANTA FE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92067
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
858-367-8660
Provider Business Practice Location Address Fax Number:
858-367-8966
Provider Enumeration Date:
04/03/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  5641 , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 111N00000X , with the licence number: 33933 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 33933 . This is a "CHIROPRACTIC LICENSE" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".




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