Gerard A. Jansen, D.C., L.AC.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

08000718 Issued in IN

Practice address

402 N Riley St
Kendallville, IN 46755-1262

Phone

(260) 347-1150

Fax

(260) 347-1155

NPI assigned

Apr 24, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1145836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285200000000",
    "number": "1740246263",
    "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": {
        "last_name": "JANSEN",
        "first_name": "GERARD",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "D.C., L.AC.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-24",
        "last_updated": "2010-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IN",
            "license": "08000718",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "350011194",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM/BCBS",
            "identifier": "000000184397",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100189090A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Yvette Jacobs
• Abdali S. Jan, M.D.
• Jansen & Jansen, D.C., Inc.
• Jansen Family Dentistry, P.C.
• Douglas A Jansen, DDS
• James S Jansen
• Janaya L Jansen, DDS
• Thomas L. Jansen, D.C., F.A.C.O.
• Jones Family Dental, LLC
• Bridget Joseph

• Chiropractor in Kendallville, IN
• Providers in Kendallville, IN by specialty
• Chiropractor in Indiana

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.