Organization Active NPI

JB Wellness PA

Doing business as JB Family & Animal Chiropractic

  • Chiropractor
  • Van Buren, AR
National Provider Identifier
1174107593
Registry record updated Jul 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
JB WELLNESS PA
Doing business as
JB Family & Animal Chiropractic
Practice address
139 Northridge Dr E Ste 2
Van Buren, AR 72956-5184
Phone
(479) 414-4336
NPI assigned
May 11, 2021
Last updated
Jul 7, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2021

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

Authorized official

Name
Dr. Jordana Ellen Amelia Beutelschies, DCNPI 1407260631
Title
Chiropractor
Phone
(479) 414-4336

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X NU Primary

Addresses

Primary practice location

139 Northridge Dr E Ste 2
Van Buren, AR 72956-5184

Mailing address

4015 N Rudy Rd
Van Buren, AR 72956-9109
Phone (479) 414-4336

Other names 1

  • JB Family & Animal Chiropractic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210708001260 AR Part B Supplier - Clinic/Group Practice 6709288152 Receives reassigned benefits from 1 practitioner
Practice locations: Van Buren, AR

National Provider Directory

National Provider Directory

Locations

139 Northridge Dr E
Ste 2
Van Buren, AR 72956
Phone (479) 414-4336

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1620691200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1625616000000",
    "number": "1174107593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4015 N RUDY RD",
            "city": "VAN BUREN",
            "state": "AR",
            "postal_code": "729569109",
            "telephone_number": "479-414-4336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "139 NORTHRIDGE DR E STE 2",
            "city": "VAN BUREN",
            "state": "AR",
            "postal_code": "729565184",
            "telephone_number": "479-414-4336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JB WELLNESS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-11",
        "last_updated": "2021-07-07",
        "certification_date": "2021-07-07",
        "status": "A",
        "authorized_official_last_name": "BEUTELSCHIES",
        "authorized_official_first_name": "JORDANA",
        "authorized_official_middle_name": "ELLEN AMELIA",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "479-414-4336",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "JB Family & Animal Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Van Buren, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.