Individual provider Active NPI

Jordan L Daniels, DC

  • Chiropractor
  • Vincennes, IN
National Provider Identifier
1417542309
Registry record updated Mar 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
08003219A Issued in IN
Practice address
1830 Hart St
Vincennes, IN 47591-5505
Phone
(812) 882-1241
NPI assigned
Mar 3, 2021
Last updated
Mar 3, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 08003219A IN Primary

Addresses

Primary practice location

1830 Hart St
Vincennes, IN 47591-5505

Mailing address

PO Box 751
Vincennes, IN 47591-0751
Phone (812) 882-1241

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210316001773 IN Practitioner - Chiropractic 1456767557 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Back2Health LLCGroup PAC ID 1456376912, 2 clinicians

Practice addresses (Care Compare)

1830 Hart St
Vincennes, IN 47591-5505
Phone (812) 882-1241

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
08003219AINMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Back2Health, LLC Chiropractor CurrentSince Mar 4, 2021 Accepting new patients

Locations

1830 Hart St
Vincennes, IN 47591
Phone (812) 882-1241

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": "1614729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614729600000",
    "number": "1417542309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 751",
            "city": "VINCENNES",
            "state": "IN",
            "postal_code": "475910751",
            "telephone_number": "812-882-1241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1830 HART ST",
            "city": "VINCENNES",
            "state": "IN",
            "postal_code": "475915505",
            "telephone_number": "812-882-1241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANIELS",
        "first_name": "JORDAN",
        "middle_name": "L",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-03",
        "last_updated": "2021-03-03",
        "certification_date": "2021-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IN",
            "license": "08003219A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vincennes, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 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.