Individual provider Active NPI

Jason Lee Rourke, B.S., D.C.

  • Chiropractor
  • Edinboro, PA
National Provider Identifier
1528307642
Registry record updated Apr 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC010698 Issued in PA
Practice address
106 Waterford St
Edinboro, PA 16412
Phone
(814) 730-2666
Fax
(814) 286-9420
NPI assigned
Feb 8, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 3, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC010698 PA Primary

Addresses

Primary practice location

106 Waterford St
Edinboro, PA 16412

Mailing address

106 Waterford St
Edinboro, PA 16412
Phone (814) 730-2666

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130318000086 PA Practitioner - Chiropractic 1951546167 Practice locations: Edinboro, PA

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
New York Chiropractic College, 2012
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

106 Waterford St
Edinboro, PA 16412-6006
Phone (814) 730-2666

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Bachelor of Science

State licenses

LicenseStateTypeSpecialty
DC010698PAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Pleasantview Chiropractic, LLC Chiropractor Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1360281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1396483200000",
    "number": "1528307642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 WATERFORD ST",
            "city": "EDINBORO",
            "state": "PA",
            "postal_code": "16412",
            "telephone_number": "814-730-2666",
            "fax_number": "814-286-9420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 WATERFORD ST",
            "city": "EDINBORO",
            "state": "PA",
            "postal_code": "16412",
            "telephone_number": "814-730-2666",
            "fax_number": "814-286-9420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROURKE",
        "first_name": "JASON",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "B.S., D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-02-08",
        "last_updated": "2014-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "PA",
            "license": "DC010698",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edinboro, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2014; 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.