Individual provider Active NPI

Jordan Michael Logsdon, DC

  • Chiropractor
  • Oklahoma City, OK
National Provider Identifier
1649950536
Registry record updated Jun 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4413 Issued in OK
Practice address
12301 S. Western Ave
St. B6
Oklahoma City, OK 73170-6717
Phone
(405) 637-8803
NPI assigned
Jul 24, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 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 4413 OK Primary

Addresses

Primary practice location

12301 S. Western Ave
St. B6
Oklahoma City, OK 73170-6717

Mailing address

220 SW 167TH Ter
Oklahoma City, OK 73170-6717
Phone (405) 637-8803

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230920000509 OK Practitioner - Chiropractic 9234593518 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

12301 S Western Ave
Suite B6
Oklahoma City, OK 73170-6116
Phone (405) 548-5372

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4413OKMDChiropractor

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": "1690156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751241600000",
    "number": "1649950536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 SW 167TH TER",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731706717",
            "telephone_number": "405-637-8803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12301 S. WESTERN AVE",
            "address_2": "ST. B6",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731706717",
            "telephone_number": "405-637-8803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOGSDON",
        "first_name": "JORDAN",
        "middle_name": "MICHAEL",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-07-24",
        "last_updated": "2025-06-30",
        "certification_date": "2025-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OK",
            "license": "4413",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 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.