Individual provider Active NPI

Jordan Michael Rutz, D.C.

  • Nutrition Chiropractor
  • Cuyahoga Falls, OH
National Provider Identifier
1679938559
Registry record updated Jan 23, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nutrition ChiropractorTaxonomy code 111NN1001X
License
4579 Issued in OH
Practice address
716 Howe Ave
Cuyahoga Falls, OH 44221-5124
Phone
(330) 836-3333
Fax
(330) 836-3335
NPI assigned
Dec 21, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nutrition Chiropractor 111NN1001X 4579 OH Primary

Addresses

Primary practice location

716 Howe Ave
Cuyahoga Falls, OH 44221-5124

Mailing address

716 Howe Ave
Cuyahoga Falls, OH 44221-5124
Phone (330) 836-3333

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191029000895 OH Practitioner - Chiropractic 5294067013 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
New York Chiropractic College, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advanced Spine Joint and Wellness CenterGroup PAC ID 6103066089, 4 clinicians

Practice addresses (Care Compare)

5020 Victor Dr
Medina, OH 44256-9688
Phone (330) 721-6504

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4579OHMDClinical Neuropsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Spine Joint and Wellness Center CurrentSince Aug 6, 2020 Accepting new patients
Fairlawn Foot & Ankle Clinic Inc PastSince Oct 1, 2019 Accepting new patients

Locations

5020 Victor Dr
Medina, OH 44256
Phone (330) 433-4243

Organizations & group practices 2

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": "1450656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485129600000",
    "number": "1679938559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "716 HOWE AVE",
            "city": "CUYAHOGA FALLS",
            "state": "OH",
            "postal_code": "442215124",
            "telephone_number": "330-836-3333",
            "fax_number": "330-836-3335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "716 HOWE AVE",
            "city": "CUYAHOGA FALLS",
            "state": "OH",
            "postal_code": "442215124",
            "telephone_number": "330-836-3333",
            "fax_number": "330-836-3335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUTZ",
        "first_name": "JORDAN",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-12-21",
        "last_updated": "2017-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NN1001X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Nutrition",
            "state": "OH",
            "license": "4579",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cuyahoga Falls, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2017; 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.