Active NPI
Kevin S. Jordan, D.C.
- Chiropractor
- Mentor, OH
National Provider Identifier
1407998628
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 1989
- Practice address
- 8889 Mentor Avenue
Mentor, OH 44060 - Phone
- (440) 205-1889
- Fax
- (440) 205-1890
- NPI assigned
- Feb 13, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 1989 | OH | Primary |
Addresses
Primary practice location
8889 Mentor Avenue
Mentor, OH 44060
Mailing address
8889 Mentor Avenue
Mentor, OH 44060
Phone (440) 205-1889
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 34-1843246-00 | Other | OH | BWC PROVIDER NUMBER |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 1989 | OH | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171324800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1447372800000",
"number": "1407998628",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8889 MENTOR AVENUE",
"city": "MENTOR",
"state": "OH",
"postal_code": "44060",
"telephone_number": "440-205-1889",
"fax_number": "440-205-1890"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8889 MENTOR AVENUE",
"city": "MENTOR",
"state": "OH",
"postal_code": "44060",
"telephone_number": "440-205-1889",
"fax_number": "440-205-1890"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JORDAN",
"first_name": "KEVIN",
"middle_name": "S.",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-02-13",
"last_updated": "2015-11-13",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "OH",
"license": "1989",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BWC PROVIDER NUMBER",
"identifier": "34-1843246-00",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Mentor, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.