Individual provider Active NPI

Jason Lee Mulder, D.C.

  • Chiropractor
  • Surprise, AZ
National Provider Identifier
1417072109
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
7810 Issued in AZ
Practice address
18761 N Reems Rd
Suite 400
Surprise, AZ 85374-8646
Phone
(623) 583-9180
Fax
(623) 583-2871
NPI assigned
Mar 20, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 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 7810 AZ Primary

Addresses

Primary practice location

18761 N Reems Rd
Suite 400
Surprise, AZ 85374-8646

Mailing address

18517 W Port Au Prince LN
Surprise, AZ 85388-7577
Phone (623) 215-8621

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)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
True Diabetes Neuropathy & Wound Solutions Az LLC PastSince Apr 24, 2023 Accepting new patients
True Health Family Medicine Az PastSince Apr 20, 2022 Accepting new patients
Adjusted 4 Life Chiropractic LLC Chiropractor Past Accepting new patients
Natural Choice Family Wellness, LLC Past Accepting new patients
True Health Baseline, LLC PastSince May 7, 2018 Accepting new patients

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1417072109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18517 W PORT AU PRINCE LN",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853887577",
            "telephone_number": "623-215-8621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18761 N REEMS RD",
            "address_2": "SUITE 400",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853748646",
            "telephone_number": "623-583-9180",
            "fax_number": "623-583-2871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULDER",
        "first_name": "JASON",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AZ",
            "license": "7810",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Surprise, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.