Active NPI
David S Jensen, DC
- Sports Physician Chiropractor
- Basalt, CO
National Provider Identifier
1215083241
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Sports Physician Chiropractor
- License
- 4085
- Practice address
- 110 Midland Ave
Ste 2
Basalt, CO 81621-8305 - Phone
- (970) 279-4099
- Fax
- (970) 797-4812
- NPI assigned
- Jan 25, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Sports Physician Chiropractor | 111NS0005X | 4085 | CO | Primary |
Addresses
Primary practice location
110 Midland Ave
Ste 2
Basalt, CO 81621-8305
Mailing address
110 Midland Ave Ste 2
Basalt, CO 81621-8305
Phone (970) 279-4099
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CO
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050919000506 | CO | Practitioner - Chiropractic | 1951395656 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Other, 1994
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
60 El Jebel Rd
Unit 56
Carbondale, CO 81623-8526
Phone (970) 279-4099
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4085 | CO | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Alpine Medicinals | Past | 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.
-
- Chiropractor
- Basalt, CO
- NPI 1962630681
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169683200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1314144000000",
"number": "1215083241",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "110 MIDLAND AVE STE 2",
"city": "BASALT",
"state": "CO",
"postal_code": "816218305",
"telephone_number": "970-279-4099",
"fax_number": "970-797-4812"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "110 MIDLAND AVE",
"address_2": "STE 2",
"city": "BASALT",
"state": "CO",
"postal_code": "816218305",
"telephone_number": "970-279-4099",
"fax_number": "970-797-4812"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JENSEN",
"first_name": "DAVID",
"middle_name": "S",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-25",
"last_updated": "2011-08-24",
"status": "A"
},
"taxonomies": [
{
"code": "111NS0005X",
"taxonomy_group": "",
"desc": "Chiropractor, Sports Physician",
"state": "CO",
"license": "4085",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Basalt, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2011; 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.