Individual provider Active NPI

Jared Kennedy, DC

  • Chiropractor
  • Waterloo, IA
National Provider Identifier
1629933155
Registry record updated Dec 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
136117 Issued in IA
Practice address
205 E Tower Park Dr
Waterloo, IA 50701-9321
Phone
(507) 525-7532
NPI assigned
Dec 17, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 136117 IA Primary

Addresses

Primary practice location

205 E Tower Park Dr
Waterloo, IA 50701-9321

Mailing address

205 E Tower Park Dr
Waterloo, IA 50701-9321

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260227001090 IA Practitioner - Chiropractic 7719468719 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Northwestern College of Chiropractic, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

205 E Tower Park Dr
Waterloo, IA 50701-9321

309 Springfield Ave
Apt 11
Hudson, IA 50643-9723

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
136117IAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Whats Next Chiropractic Chiropractor CurrentSince Dec 10, 2025 Accepting new patients

Locations

205 E Tower Park Dr
Waterloo, IA 50701
Phone (319) 380-4800

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1765929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766016000000",
    "number": "1629933155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 E TOWER PARK DR",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507019321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 E TOWER PARK DR",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507019321",
            "telephone_number": "507-525-7532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "JARED",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-12-17",
        "last_updated": "2025-12-18",
        "certification_date": "2025-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IA",
            "license": "136117",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterloo, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2025; 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.