Active NPI
Jordan Daniel Rasch
- Sports Physician Chiropractor
- Dallas, TX
National Provider Identifier
1740934355
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Sports Physician Chiropractor
- License
- 15033
- Practice address
- 4302 W Lovers LN
Dallas, TX 75209-2804 - Phone
- (214) 862-1469
- NPI assigned
- Feb 11, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Sports Physician Chiropractor | 111NS0005X | 15033 | TX | Primary |
Addresses
Primary practice location
4302 W Lovers LN
Dallas, TX 75209-2804
Mailing address
14155 Dallas Pkwy Apt 1353
Dallas, TX 75254-4450
Phone (618) 530-3694
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15033 | TX | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1644537600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1644537600000",
"number": "1740934355",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14155 DALLAS PKWY APT 1353",
"city": "DALLAS",
"state": "TX",
"postal_code": "752544450",
"telephone_number": "618-530-3694"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4302 W LOVERS LN",
"city": "DALLAS",
"state": "TX",
"postal_code": "752092804",
"telephone_number": "214-862-1469"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RASCH",
"first_name": "JORDAN",
"middle_name": "DANIEL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-02-11",
"last_updated": "2022-02-11",
"certification_date": "2022-02-11",
"status": "A"
},
"taxonomies": [
{
"code": "111NS0005X",
"taxonomy_group": "",
"desc": "Chiropractor, Sports Physician",
"state": "TX",
"license": "15033",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.