Individual provider Active NPI

Jordan Clifton Hines

  • Chiropractor
  • Santa Maria, CA
National Provider Identifier
1083221048
Registry record updated Sep 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
34932 Issued in CA
Practice address
1415 E Main St
Santa Maria, CA 93454-4801
Phone
(805) 922-1721
NPI assigned
Sep 24, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 24, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 34932 CA Primary

Addresses

Primary practice location

1415 E Main St
Santa Maria, CA 93454-4801

Mailing address

1415 E Main St
Santa Maria, CA 93454-4801
Phone (805) 922-1721

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201006001267 CA Practitioner - Chiropractic 6002235355 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2020
Medicare assignment
May accept Medicare assignment
Group practices
Pierce Chiropractic and Sports Injury Center P CGroup PAC ID 5092094748, 3 clinicians

Practice addresses (Care Compare)

1415 E Main St
Santa Maria, CA 93454-4801
Phone (805) 922-1721

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Pierce Chiropractic & Sports Injury Center Chiropractor PastSince Sep 23, 2020 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1600905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600905600000",
    "number": "1083221048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1415 E MAIN ST",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934544801",
            "telephone_number": "805-922-1721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1415 E MAIN ST",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934544801",
            "telephone_number": "805-922-1721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HINES",
        "first_name": "JORDAN",
        "middle_name": "CLIFTON",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-09-24",
        "last_updated": "2020-09-24",
        "certification_date": "2020-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "34932",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Maria, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2020; 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.