Individual provider Active NPI

Rebecca J Jordan, DC

  • Chiropractor
  • Wichita, KS
National Provider Identifier
1598875569
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
01-04272 Issued in KS
Practice address
555 N McLean Blvd
Suite 300
Wichita, KS 67203-5815
Phone
(316) 269-2692
Fax
(316) 269-4443
NPI assigned
Aug 30, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 01-04272 KS Primary

Addresses

Primary practice location

555 N McLean Blvd
Suite 300
Wichita, KS 67203-5815

Mailing address

555 N McLean Blvd
Suite 300
Wichita, KS 67203-5815
Phone (316) 269-2692

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101004000908 KS Practitioner - Chiropractic 6709078108 Reassigns benefits to 1 organization
Receives reassigned benefits from 2 practitioners
Practice locations: Wichita, KS

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
01-04272KSMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Jordan Chiropractic LLC Chiropractor CurrentSince May 1, 2023 Accepting new patients
Jordan Chiropractic Chiropractor PastSince Aug 24, 2000 Accepting new patients

Locations

2604 W 9th St N
Ste 100
Wichita, KS 67203
Phone (316) 269-2692

Practitioners & affiliated clinicians

Practitioners 2

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.

Organizations & group practices 2

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": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1598875569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 N MCLEAN BLVD",
            "address_2": "SUITE 300",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672035815",
            "telephone_number": "316-269-2692",
            "fax_number": "316-269-4443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 N MCLEAN BLVD",
            "address_2": "SUITE 300",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672035815",
            "telephone_number": "316-269-2692",
            "fax_number": "316-269-4443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "REBECCA",
        "middle_name": "J",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "KS",
            "license": "01-04272",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.