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
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4606 | KY | MD | Chiropractor |
| 2010040956 | MO | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Family Chiropractic | Chiropractor | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000298359 | Other | KY | BCBS |
| 85003119 | Medicaid | KY | |
| 50001171 | Other | KY | PASSPORT |
NPI Registry JSON
{
"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": []
}
Other providers in Republic, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 22, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.