Jeff S Jordan, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

DC 24148 Issued in CA

Practice address

819 N Harbor Dr Ste a-100
Redondo Beach, CA 90277-2006

Phone

(310) 937-2600

NPI assigned

May 22, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• The Back Center Other name

Electronic endpoints 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

• Jordan Chiropractic Corp.

  • Chiropractor
  • Redondo Beach, CA
  • NPI 1740432111
  NPD

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629936000000",
    "number": "1609086537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "819 N HARBOR DR STE A100",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902772006",
            "telephone_number": "310-937-2600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "819 N HARBOR DR STE A-100",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902772006",
            "telephone_number": "310-937-2600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "JEFF",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-22",
        "last_updated": "2021-08-26",
        "certification_date": "2020-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC24148",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC 24148",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF CALIFORNIA BOARD OF CHIROPRACTIC",
            "identifier": "DC24148",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "billing@thebackcenter.com",
            "affiliation": "N",
            "endpointDescription": "secure billing",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "819 N Harbor Dr Ste A-100",
            "city": "Redondo Beach",
            "state": "CA",
            "country_code": "US",
            "postal_code": "902772006",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "billing@thebackcenter.com",
            "affiliation": "N",
            "endpointDescription": "secure billing email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "819 N Harbor Dr Ste A-100",
            "city": "Redondo Beach",
            "state": "CA",
            "country_code": "US",
            "postal_code": "902772006",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "billing@thebackcenter.com",
            "affiliation": "N",
            "endpointDescription": "secure billing",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "28645 S Western Ave",
            "city": "Rancho Palos Verdes",
            "state": "CA",
            "country_code": "US",
            "postal_code": "902750811",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "THE",
            "last_name": "CENTER",
            "middle_name": "BACK",
            "credential": "DBA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Shannon Nicole Janet Jontz, L. AC.
• Vania L Jonusan
• Jordan Chiropractic Corp.
• David Joseph Jordan
• Diane Marie Jordan, DC
• Kalayla Ashlei Jordan
• Robin W Josefsson, D.C.
• Kelly Ann Josephsen, PA
• Aarchan R Joshi, M.D.
• Maira Liliana Juarez, MSW

• Chiropractor in Redondo Beach, CA
• Providers in Redondo Beach, CA by specialty
• Chiropractor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.