Individual provider Active NPI

Payton Jordon, DC

  • Chiropractor
  • Springfield, IL
National Provider Identifier
1285199166
Registry record updated Jan 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIA-1915 Issued in ID
Practice address
7012 Kingsmill CT
Springfield, IL 62711-7387
Phone
(217) 891-4551
NPI assigned
Feb 5, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CHIA-1915 ID Primary

Addresses

Primary practice location

7012 Kingsmill CT
Springfield, IL 62711-7387

Mailing address

7012 Kingsmill CT
Springfield, IL 62711-7387
Phone (217) 891-4551

Other practice location 1

2300 S Orchard St Ste B
Boise, ID 83705-6723
Phone (208) 383-3703

Other practice location 2

50 S Broadway Ave
Boise, ID 83702-7283
Phone (208) 345-2211

Other practice location 3

1016 E Chicago St Ste 105
Caldwell, ID 83605-5532
Phone (208) 453-6311

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220504002849 IL Practitioner - Chiropractic 5193057388 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
True Roots Chiropractic and Wellness PLLCGroup PAC ID 2668704859, 2 clinicians

Practice addresses (Care Compare)

3330 Ginger Creek Dr
Suite B
Springfield, IL 62711-7279

3330 Ginger Creek Dr
Suite B
Springfield, IL 62711-9626
Phone (217) 280-5513

3330 Ginger Creek Dr B
Springfield, IL 62711-9626

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CHIA-1915IDMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Herrin Chiropractic LLC Chiropractor CurrentSince Jul 17, 2022 Accepting new patients
Storey Chiropractic Clinic PC Chiropractor PastSince Sep 25, 2017 Accepting new patients
Explore Wellness, PLLC Chiropractor Past Accepting new patients

Locations

1016 E Chicago St
Ste 105
Caldwell, ID 83605
Phone (208) 453-6311

Organizations & group practices 4

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": "1549324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675036800000",
    "number": "1285199166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7012 KINGSMILL CT",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627117387",
            "telephone_number": "217-891-4551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7012 KINGSMILL CT",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627117387",
            "telephone_number": "217-891-4551"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2300 S Orchard St Ste B",
            "address_purpose": "LOCATION",
            "city": "Boise",
            "state": "ID",
            "postal_code": "837056723",
            "country_code": "US",
            "telephone_number": "208-383-3703",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "50 S Broadway Ave",
            "address_purpose": "LOCATION",
            "city": "Boise",
            "state": "ID",
            "postal_code": "837027283",
            "country_code": "US",
            "telephone_number": "208-345-2211",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1016 E Chicago St Ste 105",
            "address_purpose": "LOCATION",
            "city": "Caldwell",
            "state": "ID",
            "postal_code": "836055532",
            "country_code": "US",
            "telephone_number": "208-453-6311",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JORDON",
        "first_name": "PAYTON",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-05",
        "last_updated": "2023-01-30",
        "certification_date": "2023-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "ID",
            "license": "CHIA-1915",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2023; 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.