James Benjamin Jorgenson, D.C.
Individual provider Active NPI Chiropractor · Macon, MO
NPI 1619017902 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1619017902
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 6109 (MO)
- Practice address
- 307 Weller St
Macon, MO 63552-1942 - Phone
- (660) 385-5326
- Fax
- (660) 385-7696
- NPI assigned
- Feb 7, 2007
- Sex
- Male
- Sole proprietor
- Yes
Medicare Care Compare profile
- Specialty
- Chiropractic
- Education
- Palmer College Chiropractic - Davenport, 1986
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
307 Weller St
Macon, MO 63552-1942
Phone (660) 385-5326
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120223000792 | MO | Practitioner - Chiropractic | 9335307263 | Practice locations: Macon, MO |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6109 | MO | MD | Chiropractor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 6109 | MO | Yes |
Addresses
Primary practice location
307 Weller St
Macon, MO 63552-1942
Mailing address
307 Weller St
Macon, MO 63552-1942
Phone (660) 385-5326
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 288914 | Other | MO | HEALTHLINK |
| 4586 | Other | MO | BLUE CROSS BLUE SHIELD |
Other providers in Macon, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.