Individual provider Active NPI

Jacob William Morgan, D.C.

  • Chiropractor
  • Austin, MN
National Provider Identifier
1467686261
Registry record updated Apr 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5222 Issued in MN
Practice address
704 W Oakland Ave
Austin, MN 55912-2318
Phone
(507) 433-4013
Fax
(507) 433-4026
NPI assigned
May 7, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 5, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 5222 MN Primary

Addresses

Primary practice location

704 W Oakland Ave
Austin, MN 55912-2318

Mailing address

401 Broadway St S
Jordan, MN 55352-1701
Phone (612) 229-7560

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100305000399 MN Practitioner - Chiropractic 0244375939 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bollingberg Chiropractic Clinic LLPGroup PAC ID 6901993633, 3 clinicians

Practice addresses (Care Compare)

704 W Oakland Ave
Austin, MN 55912-2318
Phone (507) 433-4013

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5222MNMDThoracic Surgery (Cardiothoracic Vascular Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bollingberg Chiropractic Clinic LLP Chiropractor CurrentSince Mar 27, 2017 Accepting new patients
Penney Family Chiropractic, LLC Chiropractor PastSince Apr 11, 2014 Accepting new patients

Locations

704 W Oakland Ave
Austin, MN 55912
Phone (507) 433-4013

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1241654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554422400000",
    "number": "1467686261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 BROADWAY ST S",
            "city": "JORDAN",
            "state": "MN",
            "postal_code": "553521701",
            "telephone_number": "612-229-7560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "704 W OAKLAND AVE",
            "city": "AUSTIN",
            "state": "MN",
            "postal_code": "559122318",
            "telephone_number": "507-433-4013",
            "fax_number": "507-433-4026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORGAN",
        "first_name": "JACOB",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-05-07",
        "last_updated": "2019-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "5222",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2019; 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.