Active NPI
Jordan Michael Degrazia, D.C.
- Chiropractor
- Iowa City, IA
National Provider Identifier
1487633632
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 06528
- Practice address
- 610 Eastbury Dr.
Suite 3
Iowa City, IA 52245 - Phone
- (319) 887-6992
- Fax
- (319) 887-6983
- NPI assigned
- Jan 14, 2006
- Sex
- Male
- Sole proprietor
- No
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 | 06528 | IA | Primary |
Addresses
Primary practice location
610 Eastbury Dr.
Suite 3
Iowa City, IA 52245
Mailing address
610 Eastbury Drive
Suite 3
Iowa City, IA 52245
Phone (319) 887-6992
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0265678 | Medicaid | IA | |
| 50709 | Other | IA | BLUE CROSS & BLUE SHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IA
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- National College of Chiropractic, 2002
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
610 Eastbury Dr
Unit 3
Iowa City, IA 52245-7603
Phone (319) 887-6992
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
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 and National Provider Directory roles.
-
- Chiropractor
- Iowa City, IA
- NPI 1417149493
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1137196800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1487633632",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "610 EASTBURY DRIVE",
"address_2": "SUITE 3",
"city": "IOWA CITY",
"state": "IA",
"postal_code": "52245",
"telephone_number": "319-887-6992",
"fax_number": "319-887-6983"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "610 EASTBURY DR.",
"address_2": "SUITE 3",
"city": "IOWA CITY",
"state": "IA",
"postal_code": "52245",
"telephone_number": "319-887-6992",
"fax_number": "319-887-6983"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEGRAZIA",
"first_name": "JORDAN",
"middle_name": "MICHAEL",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-14",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "IA",
"license": "06528",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0265678",
"state": "IA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS & BLUE SHIELD",
"identifier": "50709",
"state": "IA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Iowa City, IA
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.
- 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.