Individual provider Active NPI

Jonathon Michael Anderson, D.C.

  • Chiropractor
  • Syracuse, KS
National Provider Identifier
1619920915
Registry record updated Feb 16, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
01-05027 Issued in KS
Practice address
207 N. Main
Syracuse, KS 67878
Phone
(620) 384-5338
NPI assigned
May 18, 2006
Last updated
Feb 16, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 16, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 5623 CO
Chiropractor 111N00000X 01-05027 KS Primary

Addresses

Primary practice location

207 N. Main
Syracuse, KS 67878

Mailing address

PO Box 1345
Syracuse, KS 67878-1345
Phone (620) 384-5338

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140423001055 TX Practitioner - Chiropractic 6507815578 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anderson Chiropractic PLLCGroup PAC ID 0749411064, 2 clinicians

Practice addresses (Care Compare)

902 B Crystal Falls Pkwy
Leander, TX 78641-3646
Phone (512) 259-9922

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5623COMDProfessional Counselor
01-05027KSMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Anderson Chiropractic PLLC Chiropractor CurrentSince Jan 1, 2014 Accepting new patients

Locations

210 E 10th Ave
Springfield, CO 81073
Phone (719) 523-4101

902 Crystal Falls Pkwy
Ste B
Leander, TX 78641
Phone (512) 259-9922

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": "1147910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297814400000",
    "number": "1619920915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1345",
            "city": "SYRACUSE",
            "state": "KS",
            "postal_code": "678781345",
            "telephone_number": "620-384-5338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 N. MAIN",
            "city": "SYRACUSE",
            "state": "KS",
            "postal_code": "67878",
            "telephone_number": "620-384-5338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "JONATHON",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-18",
        "last_updated": "2011-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CO",
            "license": "5623",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "KS",
            "license": "01-05027",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2011; 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.