Individual provider Active NPI

Jessica Anne Miller, DC

  • Chiropractor
  • Lawrence, KS
National Provider Identifier
1306320742
Registry record updated Sep 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
01-05933 Issued in KS
Practice address
2311 Wakarusa Dr Ste C
Lawrence, KS 66047-3350
Phone
(573) 301-5465
Fax
(833) 300-9392
NPI assigned
Sep 21, 2018
Last updated
Sep 21, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 01-05933 KS Primary

Addresses

Primary practice location

2311 Wakarusa Dr Ste C
Lawrence, KS 66047-3350

Mailing address

2311 Wakarusa Dr Ste C
Lawrence, KS 66047-3350
Phone (573) 301-5465

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181102001338 KS Practitioner - Chiropractic 0143573493

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 2018
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2311 Wakarusa Dr
Suite C
Lawrence, KS 66047-3350

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
01-05933KSMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Back in Balance Family Chiropractic Chiropractor CurrentSince May 25, 2018 Accepting new patients

Locations

2311 Wakarusa Dr
Ste C
Lawrence, KS 66047
Phone (785) 424-7384

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": "1537488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537488000000",
    "number": "1306320742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2311 WAKARUSA DR STE C",
            "city": "LAWRENCE",
            "state": "KS",
            "postal_code": "660473350",
            "telephone_number": "573-301-5465",
            "fax_number": "833-300-9392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2311 WAKARUSA DR STE C",
            "city": "LAWRENCE",
            "state": "KS",
            "postal_code": "660473350",
            "telephone_number": "573-301-5465",
            "fax_number": "833-300-9392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "JESSICA",
        "middle_name": "ANNE",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-21",
        "last_updated": "2018-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "KS",
            "license": "01-05933",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrence, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2018; 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.