Jordan Wade Vickery, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

038.011632 Issued in IL

Practice address

12860 Troxler Ave
Highland, IL 62249-2898

Phone

(618) 654-3000

NPI assigned

Mar 2, 2010

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Specialty

Chiropractic

Education

Logan College of Chiropractic, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Infinite Healthcare Solutions IncGroup PAC ID 3375087836, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Infinite Healthcare Solutions Inc

  • Family Medicine Physician
  • Glen Carbon, IL
  • NPI 1366213415

  IL

  Medicare reassignment Care Compare group NPD
• Dr James L Rehberger PC

  • Chiropractor
  • Highland, IL
  • NPI 1710082771
  NPD (past)
• Infinite Medical Specialists PC

  • Multi-Specialty Clinic/Center
  • Glen Carbon, IL
  • NPI 1639061757

  Chiropractor

  NPD (past)

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

{
    "created_epoch": "1267488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450051200000",
    "number": "1700109923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 ZSCHOKKE ST",
            "city": "HIGHLAND",
            "state": "IL",
            "postal_code": "622491650",
            "telephone_number": "618-654-4451",
            "fax_number": "618-654-1567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12860 TROXLER AVE",
            "city": "HIGHLAND",
            "state": "IL",
            "postal_code": "622492898",
            "telephone_number": "618-654-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VICKERY",
        "first_name": "JORDAN",
        "middle_name": "WADE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-03-02",
        "last_updated": "2015-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038.011632",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sara Townsend
• Bach-Ty Thi Tran
• Samantha Turner
• Felix Flores Ungacta, MD
• Uptown Emergency Physicians LLP
• Andrew S Vitale, OT
• Rebecca A Vitale, PT
• Vitality Home Dialysis Inc.
• Vituity - Illinois Auc LLP
• Vna Homecare, Inc.

• All providers in Highland, IL
• Chiropractor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2015; 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.