Individual provider Active NPI

Jordan Frost, DC

  • Chiropractor
  • Vancouver, WA
National Provider Identifier
1063294536
Registry record updated Oct 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH61489774 Issued in WA
Practice address
300 Grand Blvd Ste B200
Vancouver, WA 98661-4937
Phone
(360) 573-5500
NPI assigned
Oct 18, 2023
Last updated
Oct 18, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH61489774 WA Primary

Addresses

Primary practice location

300 Grand Blvd Ste B200
Vancouver, WA 98661-4937

Mailing address

300 Grand Blvd Ste B200
Vancouver, WA 98661-4937

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231101002402 WA Practitioner - Chiropractic 9436505138 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH61489774WAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Gehm Chiropractic Services CurrentSince Oct 19, 2023 Accepting new patients
Hazel Dell Sports Medicine & Rehab Clinic PLLC Chiropractor CurrentSince Oct 22, 2023 Accepting new patients

Locations

300 Grand Blvd
Ste B200
Vancouver, WA 98661
Phone (360) 567-0553

601 E 22nd St
Vancouver, WA 98663
Phone (360) 513-0575

Networks

  • WA PPO C-SNP
  • devoted network organization-83621310-88c0-4660-8f8d-b8ea8f4dc04e

Organizations & group practices 2

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": "1697587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697587200000",
    "number": "1063294536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 GRAND BLVD STE B200",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986614937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 GRAND BLVD STE B200",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986614937",
            "telephone_number": "360-573-5500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FROST",
        "first_name": "JORDAN",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-10-18",
        "last_updated": "2023-10-18",
        "certification_date": "2023-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH61489774",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.