Individual provider Active NPI

Lindsay Pratt Jordan, LAC

  • Acupuncturist
  • Bend, OR
National Provider Identifier
1316114556
Registry record updated Mar 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
AC01144 Issued in OR
Practice address
1303 NE Cushing Dr
Suite 150
Bend, OR 97701-3891
Phone
(541) 382-7875
Fax
(541) 382-2181
NPI assigned
May 15, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X AC01144 OR Primary

Addresses

Primary practice location

1303 NE Cushing Dr
Suite 150
Bend, OR 97701-3891

Mailing address

805 SW Industrial Way
Suite 3
Bend, OR 97702-1093
Phone (541) 585-2529

Other identifiers 2

IdentifierTypeStateIssuer
500608082MedicaidOR
9344442OtherORCIGNA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
AC01144ORMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Nlob Inc. Acupuncturist PastSince Oct 27, 2019 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1210809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458086400000",
    "number": "1316114556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 SW INDUSTRIAL WAY",
            "address_2": "SUITE 3",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977021093",
            "telephone_number": "541-585-2529",
            "fax_number": "541-585-2536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1303 NE CUSHING DR",
            "address_2": "SUITE 150",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977013891",
            "telephone_number": "541-382-7875",
            "fax_number": "541-382-2181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "LINDSAY",
        "middle_name": "PRATT",
        "credential": "LAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-15",
        "last_updated": "2016-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "OR",
            "license": "AC01144",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500608082",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "9344442",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bend, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 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.