Active NPI
Jordan Pellien, D.C
- Chiropractor
- Austin, TX
National Provider Identifier
1629358155
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 11901
- Practice address
- 3303 Northland Dr
#216
Austin, TX 78731-4945 - Phone
- (512) 407-8292
- Fax
- (512) 519-8809
- NPI assigned
- Aug 29, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 11901 | TX | Primary |
Addresses
Primary practice location
3303 Northland Dr
#216
Austin, TX 78731-4945
Mailing address
3303 Northland Dr
#216
Austin, TX 78731-4945
Phone (512) 407-8292
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 11901 | Other | TX | TEXAS LIC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11901 | TX | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1314576000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1449100800000",
"number": "1629358155",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3303 NORTHLAND DR",
"address_2": "#216",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787314945",
"telephone_number": "512-407-8292",
"fax_number": "512-519-8809"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3303 NORTHLAND DR",
"address_2": "#216",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787314945",
"telephone_number": "512-407-8292",
"fax_number": "512-519-8809"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PELLIEN",
"first_name": "JORDAN",
"credential": "D.C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-08-29",
"last_updated": "2015-12-03",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "TX",
"license": "11901",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TEXAS LIC",
"identifier": "11901",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Austin, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.