Individual provider Active NPI

Jordan Ambrose, D.C.

  • Chiropractor
  • Salem, OR
National Provider Identifier
1063805513
Registry record updated Mar 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5161 Issued in OR
Practice address
4985 Battle Creek Rd SE Ste 140
Salem, OR 97302-9684
Phone
(971) 498-7746
Fax
(503) 483-2518
NPI assigned
Mar 9, 2015
Last updated
Mar 4, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 4, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 5161 OR Primary

Addresses

Primary practice location

4985 Battle Creek Rd SE Ste 140
Salem, OR 97302-9684

Mailing address

4985 Battle Creek Rd SE Ste 140
Salem, OR 97302-9684
Phone (971) 498-7746

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150320001858 OR Practitioner - Chiropractic 0244557734 Reassigns benefits to 1 organization
Practice locations: Salem, OR

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2013
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

4985 Battle Creek Rd SE
Suite 125
Salem, OR 97302-9684
Phone (503) 583-7194

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5161ORMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ambrose LLC Chiropractor CurrentSince Feb 1, 2016 Accepting new patients

Locations

4985 Battle Creek Rd SE
Ste 125
Salem, OR 97302
Phone (503) 583-7194

4985 Battle Creek Rd SE
Ste 140
Salem, OR 97302
Phone (971) 498-7746

Networks

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

Organizations & group practices 1

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": "1425859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772582400000",
    "number": "1063805513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4985 BATTLE CREEK RD SE STE 140",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973029684",
            "telephone_number": "971-498-7746",
            "fax_number": "503-483-2518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4985 BATTLE CREEK RD SE STE 140",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973029684",
            "telephone_number": "971-498-7746",
            "fax_number": "503-483-2518"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMBROSE",
        "first_name": "JORDAN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-03-09",
        "last_updated": "2026-03-04",
        "certification_date": "2026-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OR",
            "license": "5161",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2026; 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.