Individual provider Active NPI

David Jenson, D.C.

  • Chiropractor
  • Algona, IA
National Provider Identifier
1386630978
Registry record updated Oct 10, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5046 Issued in IA
Practice address
2211 US Highway 169 N
Algona, IA 50511-7219
Phone
(515) 295-7744
Fax
(515) 295-7370
NPI assigned
Sep 20, 2005
Reactivated
Apr 11, 2006
Last updated
Oct 10, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 10, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 5046 IA Primary

Addresses

Primary practice location

2211 US Highway 169 N
Algona, IA 50511-7219

Mailing address

2211 US Highway 169 N
Algona, IA 50511-7219
Phone (515) 295-7744

Other identifiers 3

IdentifierTypeStateIssuer
IA01568OtherIDEDI SUBMITTER
0230870MedicaidIA
23087OtherIABLUE CROSS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041221000503 IA Practitioner - Chiropractic 3577521673 Practice locations: Algona, IA

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2211 Hwy 169 N
Algona, IA 50511-7219
Phone (515) 295-7744

2211 US Hwy 169 N
Algona, IA 50511-7219

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5046IAMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1127174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191974400000",
    "number": "1386630978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2211 US HIGHWAY 169 N",
            "city": "ALGONA",
            "state": "IA",
            "postal_code": "505117219",
            "telephone_number": "515-295-7744",
            "fax_number": "515-295-7370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2211 US HIGHWAY 169 N",
            "city": "ALGONA",
            "state": "IA",
            "postal_code": "505117219",
            "telephone_number": "515-295-7744",
            "fax_number": "515-295-7370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENSON",
        "first_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-20",
        "last_updated": "2007-10-10",
        "deactivation_date": "2006-03-23",
        "reactivation_date": "2006-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IA",
            "license": "5046",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EDI SUBMITTER",
            "identifier": "IA01568",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0230870",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "23087",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Algona, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2007; 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.