Jonathan K Armstrong, D.C.

Individual provider Active NPI Chiropractor · Republic, MO

NPI 1124011630 · NPPES record last updated Sep 22, 2011

Key facts

NPI
1124011630
Entity type
Individual (NPI type 1)
Primary specialty
Chiropractor 111N00000X
License
2010040956 (MO)
Practice address
851 S Colorado
Republic, MO 65738
Phone
(417) 732-4000
Fax
(417) 732-9702
NPI assigned
Aug 30, 2005
Sex
Male
Sole proprietor
No

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 and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
4606KYMDChiropractor
2010040956MOMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Family Chiropractic Chiropractor Past
since Jan 1, 2005
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4606 KY
Chiropractor 111N00000X 2010040956 MO Yes

Addresses

Primary practice location

851 S Colorado
Republic, MO 65738

Mailing address

851 S Colorado
Republic, MO 65738
Phone (417) 732-4000

Other identifiers

IdentifierTypeStateIssuer
000000298359OtherKYBCBS
85003119MedicaidKY
50001171OtherKYPASSPORT

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Sep 22, 2011.

{
    "created_epoch": "1125360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316649600000",
    "number": "1124011630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "851 S COLORADO",
            "city": "REPUBLIC",
            "state": "MO",
            "postal_code": "65738",
            "telephone_number": "417-732-4000",
            "fax_number": "417-732-9702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "851 S COLORADO",
            "city": "REPUBLIC",
            "state": "MO",
            "postal_code": "65738",
            "telephone_number": "417-732-4000",
            "fax_number": "417-732-9702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARMSTRONG",
        "first_name": "JONATHAN",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-30",
        "last_updated": "2011-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "KY",
            "license": "4606",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "2010040956",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "000000298359",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "85003119",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT",
            "identifier": "50001171",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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Sources for this page

Verify at the official NPI Registry.