Individual provider Active NPI

Jason Matthew Sunderland, D.C.

  • Chiropractor
  • Minden, LA
National Provider Identifier
1548429772
Registry record updated Mar 24, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1433 Issued in LA
Practice address
407 Meadowview Dr
Minden, LA 71055-3522
Phone
(318) 371-9979
Fax
(318) 371-9949
NPI assigned
Jun 3, 2008
Last updated
Mar 24, 2009By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 24, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1433 LA Primary

Addresses

Primary practice location

407 Meadowview Dr
Minden, LA 71055-3522

Mailing address

407 Meadowview Dr
Minden, LA 71055-3522
Phone (318) 371-9979

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110121000719 LA Practitioner - Chiropractic 1557540606 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

603 Fleming LN
Minden, LA 71055-3073
Phone (318) 371-9979

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1433LAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Sunderland Chiropractic L.L.C Chiropractor CurrentSince Jan 13, 2011 Accepting new patients

Locations

100 Angela Ln
Minden, LA 71055
Phone (318) 371-9979

603 Fleming Ln
Minden, LA 71055
Phone (318) 371-9979

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, 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": "1212451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1237852800000",
    "number": "1548429772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "407 MEADOWVIEW DR",
            "city": "MINDEN",
            "state": "LA",
            "postal_code": "710553522",
            "telephone_number": "318-371-9979",
            "fax_number": "318-371-9949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 MEADOWVIEW DR",
            "city": "MINDEN",
            "state": "LA",
            "postal_code": "710553522",
            "telephone_number": "318-371-9979",
            "fax_number": "318-371-9949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUNDERLAND",
        "first_name": "JASON",
        "middle_name": "MATTHEW",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-06-03",
        "last_updated": "2009-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "LA",
            "license": "1433",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minden, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2009; 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.