Individual provider Active NPI

Jordan Herbert Phillips

  • Chiropractor
  • Daphne, AL
National Provider Identifier
1265279855
Registry record updated Mar 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2863 Issued in AL
Practice address
28260 US Highway 98 Ste B
Daphne, AL 36526-7075
Phone
(251) 850-4128
NPI assigned
Jul 10, 2024
Last updated
Mar 31, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 31, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2863 AL Primary

Addresses

Primary practice location

28260 US Highway 98 Ste B
Daphne, AL 36526-7075

Mailing address

28260 US Highway 98 Ste B
Daphne, AL 36526-7075

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250520002589 AL Practitioner - Chiropractic 0840718144 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gulf Coast Chiropractic LLCGroup PAC ID 3072039098, 3 clinicians

Practice addresses (Care Compare)

28260 US Hwy 98
Suite B
Daphne, AL 36526-7075
Phone (251) 850-4128

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2863ALMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Gulf Coast Chiropractic LLC Chiropractor CurrentSince Apr 28, 2025 Accepting new patients

Locations

28260 US Highway 98
Ste B
Daphne, AL 36526
Phone (251) 445-1850

Organizations & group practices 1

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": "1720569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743379200000",
    "number": "1265279855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28260 US HIGHWAY 98 STE B",
            "city": "DAPHNE",
            "state": "AL",
            "postal_code": "365267075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28260 US HIGHWAY 98 STE B",
            "city": "DAPHNE",
            "state": "AL",
            "postal_code": "365267075",
            "telephone_number": "251-850-4128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "JORDAN",
        "middle_name": "HERBERT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-07-10",
        "last_updated": "2025-03-31",
        "certification_date": "2025-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AL",
            "license": "2863",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Daphne, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2025; 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.