Individual provider Active NPI

Nicholas Bernard Jansen, D.C.

  • Chiropractor
  • Indianapolis, IN
National Provider Identifier
1124233978
Registry record updated Nov 27, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
08002328A Issued in IN
Practice address
1810 Broad Ripple Ave
Suite 9
Indianapolis, IN 46220-2363
Phone
(317) 251-1800
Fax
(317) 251-1801
NPI assigned
May 14, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 08002328A IN Primary
Acupuncturist 171100000X 81000088A IN

Addresses

Primary practice location

1810 Broad Ripple Ave
Suite 9
Indianapolis, IN 46220-2363

Mailing address

1810 Broad Ripple Ave
Suite 9
Indianapolis, IN 46220-2363
Phone (317) 251-1800

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
08002328AINMDChiropractor
81000088AINMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
LC Chiropractic PC Chiropractor PastSince Jun 19, 2000 Accepting new patients
Jansen Chiro, LLC Chiropractor Past Accepting new patients
Core Training Centers, Inc. Chiropractor PastSince Jun 4, 2006 Accepting new patients

Organizations & group practices 3

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": "1179100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1259280000000",
    "number": "1124233978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1810 BROAD RIPPLE AVE",
            "address_2": "SUITE 9",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462202363",
            "telephone_number": "317-251-1800",
            "fax_number": "317-251-1801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1810 BROAD RIPPLE AVE",
            "address_2": "SUITE 9",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462202363",
            "telephone_number": "317-251-1800",
            "fax_number": "317-251-1801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JANSEN",
        "first_name": "NICHOLAS",
        "middle_name": "BERNARD",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-14",
        "last_updated": "2009-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IN",
            "license": "08002328A",
            "primary": true
        },
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "IN",
            "license": "81000088A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.