Jordan William Pontius, DC, ATC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

038.013188 Issued in IL

Practice address

630 Terra West Dr
Freeport, IL 61032

Phone

(815) 235-7858

Fax

(815) 235-7913

NPI assigned

Feb 9, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Specialty

Chiropractic

Education

National College of Chiropractic, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hulsebus and Gehlsen ChiropracticGroup PAC ID 1557324415, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Hulsebus and Gehlsen Chiropractic

  • Chiropractor
  • Freeport, IL
  • NPI 1043433162
  Medicare reassignment Care Compare group NPD
• Jenkins Chiropractic LTD

  • Chiropractor
  • Lombard, IL
  • NPI 1588713994
  NPD (past)
• True Health Chiropractic and Acupuncture, PLLC

  • Clinic/Center
  • Lombard, IL
  • NPI 1104637677
  NPD (past)

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

{
    "created_epoch": "1518134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572480000000",
    "number": "1508365115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "627 N GREENFIELD DR",
            "city": "FREEPORT",
            "state": "IL",
            "postal_code": "610322914",
            "telephone_number": "815-990-5394",
            "fax_number": "815-235-7913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 TERRA WEST DR",
            "city": "FREEPORT",
            "state": "IL",
            "postal_code": "61032",
            "telephone_number": "815-235-7858",
            "fax_number": "815-235-7913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PONTIUS",
        "first_name": "JORDAN",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "DC, ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-02-09",
        "last_updated": "2019-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038.013188",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "765879632",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AENTA",
            "identifier": "6217986",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Trisha A Phillips, MS, CSADC, MISA I
• Kathleen Picci
• Madison E Pickard, PT
• Sarah Pillow, COTA/L
• Jerek Charles Pontius, ATC
• Powerback Rehabilitation LLC (Genesis Rehabilitation Services)
• Presence Life Connections (Ascension Living Saint Joseph Village)
• Kimberly S Price, PT
• Bradley Procek
• Courtney L Pyant-Dan-Pullo, MD

• Chiropractor in Freeport, IL
• Providers in Freeport, IL by specialty
• Chiropractor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 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.