Individual provider Active NPI

David S Jensen, DC

  • Sports Physician Chiropractor
  • Basalt, CO
National Provider Identifier
1215083241
Registry record updated Aug 24, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Physician ChiropractorTaxonomy code 111NS0005X
License
4085 Issued in CO
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

Updated by the provider on Aug 24, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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 IDStateProvider typePAC IDDetails
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

LicenseStateTypeSpecialty
4085COMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Alpine Medicinals PastSince Oct 1, 2008 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": "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.

Verify at the official NPI Registry.