Individual provider Active NPI

Jarod Keith Waters, D.C.

  • Neurology Chiropractor
  • Fountain, CO
National Provider Identifier
1093968430
Registry record updated Aug 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology ChiropractorTaxonomy code 111NN0400X
License
7180 Issued in CO
Practice address
468 N Santa Fe Ave
Fountain, CO 80817-1742
Phone
(719) 799-6555
Fax
(719) 302-5680
NPI assigned
Oct 29, 2008
Last updated
Aug 11, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Chiropractor 111NN0400X 7180 CO Primary
Nutrition Chiropractor 111NN1001X 7180 CO

Addresses

Primary practice location

468 N Santa Fe Ave
Fountain, CO 80817-1742

Mailing address

468 N Santa Fe Ave
Fountain, CO 80817-1742
Phone (719) 799-6555

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160420002020 CO Practitioner - Chiropractic 7719024660 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11020TXMDAddiction (Substance Use Disorder) Counselor
7180COMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Fountain Chiropractic and Wellness Center Neurology CurrentSince Feb 4, 2016 Accepting new patients
Fountain Chiropractic and Wellness Center CurrentSince Apr 13, 2025 Accepting new patients
American Chiropractic Clinic PastSince May 18, 2017 Accepting new patients
American Integrated Healthcare PLLC PastSince Nov 8, 2018 Accepting new patients

Locations

468 N Santa Fe Ave
Fountain, CO 80817
Phone (719) 799-6555

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": "1225238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754870400000",
    "number": "1093968430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "468 N SANTA FE AVE",
            "city": "FOUNTAIN",
            "state": "CO",
            "postal_code": "808171742",
            "telephone_number": "719-799-6555",
            "fax_number": "719-302-5680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "468 N SANTA FE AVE",
            "city": "FOUNTAIN",
            "state": "CO",
            "postal_code": "808171742",
            "telephone_number": "719-799-6555",
            "fax_number": "719-302-5680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATERS",
        "first_name": "JAROD",
        "middle_name": "KEITH",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-10-29",
        "last_updated": "2025-08-11",
        "certification_date": "2025-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NN0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Neurology",
            "state": "CO",
            "license": "7180",
            "primary": true
        },
        {
            "code": "111NN1001X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Nutrition",
            "state": "CO",
            "license": "7180",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fountain, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2025; 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.