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JACKSONVILLE CHIROPRACTIC CENTER
NPI 1649448374
Chiropractor in Phoenix, MD

Active since February 15, 2008
14307 JARRETTSVILLE PIKE, PHOENIX, MD 21131(410) 592-7300(410) 666-0348 Get Directions Write a Review

NPPES record last updated: February 15, 2008. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Jacksonville Chiropractic Center NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JACKSONVILLE CHIROPRACTIC CENTER (NPI 1649448374) is a healthcare organization registered as a chiropractor in Phoenix, Maryland and active in the NPI registry since February 2008. The organization lists Daniel Thomas Wise, Doctor/owner, as its authorized official.

NPPES Registry Identity

NPI1649448374
Entity TypeOrganization
Primary Taxonomy111N00000X
Legal Business NameJCC LLC
Location Address14307 JARRETTSVILLE PIKEPhoenix, MD 21131-1763
Mailing AddressPo Box 38, 14307 Jarrettsville PikePhoenix, MD 21131-0038 · (410) 592-7300 · Fax (410) 666-0348
Phone(410) 592-7300
Fax(410) 666-0348
Organization SubpartNo
Authorized OfficialDaniel Thomas WiseDoctor/owner · (410) 592-7300
Enumeration DateFebruary 15, 2008
✔ NPI 1649448374 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyChiropractorChiropractic Providers
Taxonomy Code111N00000X
License✔ Licensed in MD · S01332
Definition
A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.
14307 JARRETTSVILLE PIKE, Phoenix, MD 21131
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Other Names 1

Other NameJacksonville Chiropractic Center

Other Identifiers 1

Medicare PIN382MMD

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jacksonville Chiropractic Center is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by March 31, 2027

Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date
StateMarylandEnrollment IDO20140310001725Non-DME Part B · Clinic/Group PracticeDue dateMarch 31, 2027
Source: CMS Revalidation Due Date List, October 2026 release.

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Jacksonville Chiropractic Center, which bills Medicare for the services this clinician delivers.

Clinician (1)

Daniel Wise, D.C.
Chiropractic
NPI 1700903390
14307 JARRETTSVILLE PIKE
Phoenix, MD 21131
(410) 592-7300
✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jcc LLC's NPI number?

The NPI number for Jcc LLC is 1649448374. It was assigned to this organization in the NPPES registry on February 15, 2008. The provider is also known as Jacksonville Chiropractic Center.

Where is Jcc LLC located?

Jcc LLC is located at 14307 Jarrettsville Pike, Phoenix, MD 21131. The listed phone number is (410) 592-7300.

What is Jcc LLC's specialty?

The primary specialty registered for this NPI is Chiropractor with taxonomy code 111N00000X.

Is Jcc LLC enrolled in Medicare?

Yes. Jcc LLC is registered in the Medicare PECOS enrollment system.

When is Jcc LLC's Medicare revalidation due?

According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Maryland, Clinic/Group Practice) is due for revalidation by March 31, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.

How many clinicians bill Medicare through Jcc LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Chiropractic) reassigns their Medicare billing to Jcc LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Jcc LLC was last updated on February 15, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.