Individual provider Active NPI

Jessica Ellen Speidel, D.C

  • Chiropractor
  • Lawrence, KS
National Provider Identifier
1164825139
Registry record updated Oct 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
01-05661 Issued in KS
Practice address
1605 Wakarusa Dr
Lawrence, KS 66047-1805
Phone
(785) 842-4181
Fax
(785) 842-6436
NPI assigned
Oct 3, 2014
Last updated
Oct 3, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 01-05661 KS Primary

Addresses

Primary practice location

1605 Wakarusa Dr
Lawrence, KS 66047-1805

Mailing address

1605 Wakarusa Dr
Lawrence, KS 66047-1805
Phone (785) 842-4181

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141028001977 KS Practitioner - Chiropractic 7416178876 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advanced Chiropractic Services PAGroup PAC ID 8729025887, 5 clinicians

Practice addresses (Care Compare)

1605 Wakarusa Dr
Lawrence, KS 66047-1805
Phone (785) 842-4181

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
01-05661KSMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Chiropractic Services PA Chiropractor CurrentSince Oct 3, 2014 Accepting new patients
Midwest Chiropractic Services LLC Chiropractor PastSince Oct 3, 2014 Accepting new patients

Locations

1605 Wakarusa Dr
Lawrence, KS 66047
Phone (785) 842-4181

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, 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": "1412294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412294400000",
    "number": "1164825139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1605 WAKARUSA DR",
            "city": "LAWRENCE",
            "state": "KS",
            "postal_code": "660471805",
            "telephone_number": "785-842-4181",
            "fax_number": "785-842-6436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1605 WAKARUSA DR",
            "city": "LAWRENCE",
            "state": "KS",
            "postal_code": "660471805",
            "telephone_number": "785-842-4181",
            "fax_number": "785-842-6436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPEIDEL",
        "first_name": "JESSICA",
        "middle_name": "ELLEN",
        "name_prefix": "Dr.",
        "credential": "D.C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-03",
        "last_updated": "2014-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "KS",
            "license": "01-05661",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrence, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2014; 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.