Provider Demographics
NPI:1285709022
Name:GERNI, JAMES B (DC, LAC)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:B
Last Name:GERNI
Suffix:
Gender:M
Credentials:DC, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:449 E MAIN ST STE 201
Mailing Address - Street 2:
Mailing Address - City:HAGERSTOWN
Mailing Address - State:IN
Mailing Address - Zip Code:47346-1338
Mailing Address - Country:US
Mailing Address - Phone:765-530-8117
Mailing Address - Fax:765-530-8118
Practice Address - Street 1:449 E MAIN ST STE 201
Practice Address - Street 2:
Practice Address - City:HAGERSTOWN
Practice Address - State:IN
Practice Address - Zip Code:47346-1338
Practice Address - Country:US
Practice Address - Phone:765-530-8117
Practice Address - Fax:765-530-8118
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-21
Last Update Date:2010-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08001729A111N00000X
IN81000007A171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200215040AMedicaid
IN200215040AMedicaid
IN231670Medicare ID - Type Unspecified
IN200215040AMedicaid