NPIMap

Organization Active NPI

Jordan Chiropractic LLC

  • Chiropractor
  • New Albany, IN
National Provider Identifier
1306247101
Registry record updated Oct 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
08002750A Issued in IN
Legal business name
JORDAN CHIROPRACTIC LLC
Practice address
3417 Grant Line Rd # 316
Grant Line Center
New Albany, IN 47150-2164
Phone
(502) 468-0774
NPI assigned
Sep 11, 2014
Last updated
Oct 26, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2016

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

Authorized official

Name
Derek Jordan, DCNPI 1356615975
Title
Owner
Phone
(502) 468-0774

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
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 08002750A IN Primary

Addresses

Primary practice location

3417 Grant Line Rd # 316
Grant Line Center
New Albany, IN 47150-2164

Mailing address

3417 Grant Line Rd # 316
Grant Line Center
New Albany, IN 47150-2164
Phone (502) 468-0774

National Provider Directory

National Provider Directory

Locations

3417 Grant Line Rd
Ste 316
New Albany, IN 47150
Phone (502) 468-0774

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": "1410393600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1477440000000",
    "number": "1306247101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3417 GRANT LINE RD # 316",
            "address_2": "GRANT LINE CENTER",
            "city": "NEW ALBANY",
            "state": "IN",
            "postal_code": "471502164",
            "telephone_number": "502-468-0774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3417 GRANT LINE RD # 316",
            "address_2": "GRANT LINE CENTER",
            "city": "NEW ALBANY",
            "state": "IN",
            "postal_code": "471502164",
            "telephone_number": "502-468-0774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JORDAN CHIROPRACTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-11",
        "last_updated": "2016-10-26",
        "status": "A",
        "authorized_official_last_name": "JORDAN",
        "authorized_official_first_name": "DEREK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "502-468-0774",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "IN",
            "license": "08002750A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Albany, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.