Individual provider Active NPI

Joshua Middendorf, D.C.

  • Chiropractor
  • Saint Joseph, MO
National Provider Identifier
1003111956
Registry record updated Jan 24, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2011001547 Issued in MO
Practice address
1512 S 27TH St
Saint Joseph, MO 64507-1847
Phone
(816) 232-9437
NPI assigned
Jan 24, 2011
Last updated
Jan 24, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2011001547 MO Primary

Addresses

Primary practice location

1512 S 27TH St
Saint Joseph, MO 64507-1847

Mailing address

1512 S 27TH St
Saint Joseph, MO 64507-1847
Phone (816) 232-9437

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110330000632 MO Practitioner - Chiropractic 7012190978 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Performance Plus Rehabilitation Center LLCGroup PAC ID 5294791695, 8 clinicians

Practice addresses (Care Compare)

1802 N Woodbine Rd
Saint Joseph, MO 64506-3667
Phone (816) 232-5113

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2011001547MOMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Dr Gerald Yurth Chiropractor LLC Chiropractor PastSince Jan 25, 2011 Accepting new patients
Oa Centers of Kansas City, LLC Past Accepting new patients

Networks

  • IL PPO Downstate
  • devoted network organization-2b183dd2-4e80-4977-80a6-4fdf0df4361d
  • IA HMO C-SNP
  • devoted network organization-27eb9117-6975-449a-a7ad-909243995ddc
  • devoted network organization-734447cc-691b-4aa7-a112-9c9c8698dcc9
  • IA HMO

Organizations & group practices 4

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": "1295827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1295827200000",
    "number": "1003111956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1512 S 27TH ST",
            "city": "SAINT JOSEPH",
            "state": "MO",
            "postal_code": "645071847",
            "telephone_number": "816-232-9437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1512 S 27TH ST",
            "city": "SAINT JOSEPH",
            "state": "MO",
            "postal_code": "645071847",
            "telephone_number": "816-232-9437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIDDENDORF",
        "first_name": "JOSHUA",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-01-24",
        "last_updated": "2011-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "2011001547",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Joseph, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2011; 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.