Individual provider Active NPI

Jordana Ellen Amelia Beutelschies, DC

  • Chiropractor
  • Fort Smith, AR
National Provider Identifier
1407260631
Registry record updated Mar 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
16071 Issued in AR
Practice address
5600 Euper LN
Fort Smith, AR 72903-3236
Phone
(479) 484-7200
NPI assigned
Jun 16, 2014
Last updated
Mar 10, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 16071 AR Primary
Chiropractor 111N00000X 4159 OK

Addresses

Primary practice location

5600 Euper LN
Fort Smith, AR 72903-3236

Mailing address

4015 N Rudy Rd
Van Buren, AR 72956-9109
Phone (479) 414-4336

Other practice location 1

4015 N Rudy Rd
Van Buren, AR 72956
Phone (479) 414-4336

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140922001038 AR Practitioner - Chiropractic 1153540364 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

139 Northridge Dr E
2 JB Family and Animal Chiropractic
Van Buren, AR 72956-5184
Phone (479) 414-4336

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4159OKMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
JB Wellness PA Chiropractor CurrentSince May 24, 2021 Accepting new patients
Seubold Chiropractic Clinic Chiropractor PastSince Jul 26, 2014 Accepting new patients

Locations

139 Northridge Dr E
Ste 2
Van Buren, AR 72956
Phone (479) 414-4336

Organizations & group practices 2

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": "1402876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615334400000",
    "number": "1407260631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4015 N RUDY RD",
            "city": "VAN BUREN",
            "state": "AR",
            "postal_code": "729569109",
            "telephone_number": "479-414-4336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5600 EUPER LN",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729033236",
            "telephone_number": "479-484-7200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4015 N Rudy Rd",
            "address_purpose": "LOCATION",
            "city": "Van Buren",
            "state": "AR",
            "postal_code": "72956",
            "country_code": "US",
            "telephone_number": "479-414-4336",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BEUTELSCHIES",
        "first_name": "JORDANA",
        "middle_name": "ELLEN AMELIA",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-16",
        "last_updated": "2021-03-10",
        "certification_date": "2021-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AR",
            "license": "16071",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OK",
            "license": "4159",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Smith, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2021; 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.