Individual provider Active NPI

Joel Jordan, D.C.

  • Chiropractor
  • Clare, MI
National Provider Identifier
1497172563
Registry record updated Jun 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2301010262 Issued in MI
Practice address
1426 N McEwan St
Clare, MI 48617-1114
Phone
(989) 386-3838
Fax
(989) 386-2158
NPI assigned
Mar 26, 2014
Last updated
Jun 29, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 29, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2301010262 MI Primary
Chiropractor 111N00000X 08002755A IN

Addresses

Primary practice location

1426 N McEwan St
Clare, MI 48617-1114

Mailing address

1426 N McEwan St
Clare, MI 48617-1114
Phone (989) 386-3838

Other practice location 1

908 E Ireland Rd
South Bend, IN 46614-2664
Phone (574) 303-4884

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150519002742 MI Practitioner - Chiropractic 9032439880 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1426 N McEwan St
Clare, MI 48617-1114
Phone (989) 386-3446

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
08002755AINMDChiropractor
2301010262MIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Clare Alpha Chiropractic, PLLC Chiropractor CurrentSince Jun 10, 2020 Accepting new patients
Alpha Chiropractic Clinic Inc Chiropractor PastSince Nov 1, 2019 Accepting new patients

Locations

1426 N McEwan St
Clare, MI 48617
Phone (989) 386-3446

Organizations & group practices 3

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": "1395792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593388800000",
    "number": "1497172563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1426 N MCEWAN ST",
            "city": "CLARE",
            "state": "MI",
            "postal_code": "486171114",
            "telephone_number": "989-386-3838",
            "fax_number": "989-386-2158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1426 N MCEWAN ST",
            "city": "CLARE",
            "state": "MI",
            "postal_code": "486171114",
            "telephone_number": "989-386-3838",
            "fax_number": "989-386-2158"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "908 E Ireland Rd",
            "address_purpose": "LOCATION",
            "city": "South Bend",
            "state": "IN",
            "postal_code": "466142664",
            "country_code": "US",
            "telephone_number": "574-303-4884",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "JOEL",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-03-26",
        "last_updated": "2020-06-29",
        "certification_date": "2020-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301010262",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IN",
            "license": "08002755A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clare, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2020; 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.