Individual provider Active NPI

Jered Anthony Jorgensen, DC

  • Chiropractor
  • North Platte, NE
National Provider Identifier
1366689119
Registry record updated May 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1552 Issued in NE
Practice address
110 S Sherman Ave
North Platte, NE 69101-4913
Phone
(308) 534-1870
Fax
(308) 534-1871
NPI assigned
Jan 15, 2009
Last updated
May 4, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 4, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1552 NE Primary

Addresses

Primary practice location

110 S Sherman Ave
North Platte, NE 69101-4913

Mailing address

110 S Sherman Ave
North Platte, NE 69101-4913
Phone (308) 534-1870

Other identifiers 3

IdentifierTypeStateIssuer
27233OtherNEBCBS
10025712600MedicaidNE
P00678769OtherNERR MEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090203000065 NE Practitioner - Chiropractic 1951465194 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jorgensen Chiropractic Care LLCGroup PAC ID 9335203835, 2 clinicians

Practice addresses (Care Compare)

110 S Sherman Ave
North Platte, NE 69101-4913
Phone (308) 534-1870

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Jorgensen Chiropractic Care LLC Chiropractor CurrentSince Jan 22, 2009 Accepting new patients

Locations

110 S Sherman Ave
North Platte, NE 69101
Phone (308) 534-1870

333 Maple St
#105
Sutherland, NE 69165
Phone (308) 386-4799

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": "1231977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651622400000",
    "number": "1366689119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 S SHERMAN AVE",
            "city": "NORTH PLATTE",
            "state": "NE",
            "postal_code": "691014913",
            "telephone_number": "308-534-1870",
            "fax_number": "308-534-1871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 S SHERMAN AVE",
            "city": "NORTH PLATTE",
            "state": "NE",
            "postal_code": "691014913",
            "telephone_number": "308-534-1870",
            "fax_number": "308-534-1871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORGENSEN",
        "first_name": "JERED",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-01-15",
        "last_updated": "2022-05-04",
        "certification_date": "2022-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NE",
            "license": "1552",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "27233",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025712600",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00678769",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Platte, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2022; 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.