Organization Active NPI

Kelli Jordan Inc.

  • Chiropractor
  • Marble Falls, TX
National Provider Identifier
1346331923
Registry record updated Sep 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4973 Issued in TX
Legal business name
KELLI JORDAN INC.
Practice address
100 Main St
Marble Falls, TX 78654-5723
Phone
(830) 693-1985
Fax
(830) 693-8167
NPI assigned
Sep 27, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2008

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

Authorized official

Name
Dr. Kelli Jordan, D.C.
Title
President
Phone
(830) 693-1985

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 4973 TX Primary

Addresses

Primary practice location

100 Main St
Marble Falls, TX 78654-5723

Mailing address

100 Main Street
Marble Falls, TX 78654
Phone (830) 693-1985

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070212000229 TX Part B Supplier - Clinic/Group Practice 0547262149 Receives reassigned benefits from 1 practitioner
Practice locations: Marble Falls, TX

National Provider Directory

National Provider Directory

Locations

700 N Lamar Blvd
Ste 150
Austin, TX 78703
Phone (512) 542-9191

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1220572800000",
    "number": "1346331923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MAIN STREET",
            "city": "MARBLE FALLS",
            "state": "TX",
            "postal_code": "78654",
            "telephone_number": "830-693-1985",
            "fax_number": "830-693-8167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MAIN ST",
            "city": "MARBLE FALLS",
            "state": "TX",
            "postal_code": "786545723",
            "telephone_number": "830-693-1985",
            "fax_number": "830-693-8167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KELLI JORDAN INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-27",
        "last_updated": "2008-09-05",
        "status": "A",
        "authorized_official_last_name": "JORDAN",
        "authorized_official_first_name": "KELLI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "830-693-1985",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "4973",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marble Falls, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.