Individual provider Active NPI

Jaron R Soren, DC

  • Chiropractor
  • Caldwell, ID
National Provider Identifier
1124350020
Registry record updated Sep 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIA-1490 Issued in ID
Practice address
309 E Logan St
Caldwell, ID 83605-4863
Phone
(208) 455-0678
Fax
(208) 455-0679
NPI assigned
Feb 3, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 10, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CHIA-1490 ID Primary

Addresses

Primary practice location

309 E Logan St
Caldwell, ID 83605-4863

Mailing address

309 E Logan St
Caldwell, ID 83605-4863
Phone (208) 455-0678

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120925000742 ID Practitioner - Chiropractic 1557559226 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
New York Chiropractic College, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

309 E Logan St
Caldwell, ID 83605-4863
Phone (208) 455-0678

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CHIA-1490IDMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Total Performance Sports Medicine, PC Chiropractor PastSince Jan 1, 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": "1265155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378771200000",
    "number": "1124350020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "309 E LOGAN ST",
            "city": "CALDWELL",
            "state": "ID",
            "postal_code": "836054863",
            "telephone_number": "208-455-0678",
            "fax_number": "208-455-0679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 E LOGAN ST",
            "city": "CALDWELL",
            "state": "ID",
            "postal_code": "836054863",
            "telephone_number": "208-455-0678",
            "fax_number": "208-455-0679"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOREN",
        "first_name": "JARON",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-02-03",
        "last_updated": "2013-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "ID",
            "license": "CHIA-1490",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Caldwell, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2013; 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.