Organization Active NPI

Broadstone Chiropractic Collins, Inc.

  • Chiropractor
  • Folsom, CA
National Provider Identifier
1508491259
Registry record updated Jul 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
BROADSTONE CHIROPRACTIC COLLINS, INC.
Practice address
1837 Iron Point Rd Ste 140
Folsom, CA 95630-8781
Phone
(916) 983-7771
Fax
(916) 983-7996
NPI assigned
Mar 3, 2020
Last updated
Jul 27, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2023

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

Authorized official

Name
Dr. Jandy Collins, DCNPI 1427486372
Title
Owner/Chiropractor
Phone
(916) 983-7771

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X NU Primary

Addresses

Primary practice location

1837 Iron Point Rd Ste 140
Folsom, CA 95630-8781

Mailing address

1837 Iron Point Rd Ste 140
Folsom, CA 95630-8781
Phone (916) 983-7771

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200423003138 CA Part B Supplier - Clinic/Group Practice 0840620324 Receives reassigned benefits from 1 practitioner
Practice locations: Folsom, CA

National Provider Directory

National Provider Directory

Locations

1837 Iron Point Rd
Ste 140
Folsom, CA 95630
Phone (916) 850-0034

2690 E Bidwell St
Ste 400
Folsom, CA 95630
Phone (916) 983-7771

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1583193600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690416000000",
    "number": "1508491259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1837 IRON POINT RD STE 140",
            "city": "FOLSOM",
            "state": "CA",
            "postal_code": "956308781",
            "telephone_number": "916-983-7771",
            "fax_number": "916-983-7996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1837 IRON POINT RD STE 140",
            "city": "FOLSOM",
            "state": "CA",
            "postal_code": "956308781",
            "telephone_number": "916-983-7771",
            "fax_number": "916-983-7996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROADSTONE CHIROPRACTIC COLLINS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-03",
        "last_updated": "2023-07-27",
        "certification_date": "2023-07-27",
        "status": "A",
        "authorized_official_last_name": "COLLINS",
        "authorized_official_first_name": "JANDY",
        "authorized_official_title_or_position": "OWNER/CHIROPRACTOR",
        "authorized_official_telephone_number": "916-983-7771",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Folsom, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.