Organization Active NPI

Jansen & Jansen, D.C., Inc.

Doing business as Jansen Family Chiropractic

  • Chiropractor
  • Kendallville, IN
National Provider Identifier
1679583876
Registry record updated Sep 23, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
111N00000X Issued in IN
Legal business name
JANSEN & JANSEN, D.C., INC.
Doing business as
Jansen Family Chiropractic
Practice address
402 N Riley St
Kendallville, IN 46755-1262
Phone
(260) 347-1150
Fax
(260) 347-1155
NPI assigned
Aug 9, 2006
Last updated
Sep 23, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2010

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

Authorized official

Name
Dr. Thomas L. Jansen, D.C.NPI 1750347324
Title
President
Phone
(260) 347-1150

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 111N00000X IN Primary

Addresses

Primary practice location

402 N Riley St
Kendallville, IN 46755-1262

Mailing address

402 N Riley St
Kendallville, IN 46755-1262
Phone (260) 347-1150

Other identifiers 1

IdentifierTypeStateIssuer
100190920AMedicaidIN

Other names 1

  • Jansen Family Chiropractic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040913000402 IN Part B Supplier - Clinic/Group Practice 3173590916 Receives reassigned benefits from 2 practitioners
Practice locations: Kendallville, IN

National Provider Directory

National Provider Directory

Locations

402 N Riley St
Kendallville, IN 46755
Phone (260) 242-0836

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1155081600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1285200000000",
    "number": "1679583876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "402 N RILEY ST",
            "city": "KENDALLVILLE",
            "state": "IN",
            "postal_code": "467551262",
            "telephone_number": "260-347-1150",
            "fax_number": "260-347-1155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 N RILEY ST",
            "city": "KENDALLVILLE",
            "state": "IN",
            "postal_code": "467551262",
            "telephone_number": "260-347-1150",
            "fax_number": "260-347-1155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JANSEN & JANSEN, D.C., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-09",
        "last_updated": "2010-09-23",
        "status": "A",
        "authorized_official_last_name": "JANSEN",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "260-347-1150",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IN",
            "license": "111N00000X",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100190920A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jansen Family Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kendallville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.