Individual provider Active NPI

Jordan Weil, DC

  • Chiropractor
  • Eau Claire, WI
National Provider Identifier
1760003974
Registry record updated Feb 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5527-12 Issued in WI
Practice address
4210 Southtowne Drive
Eau Claire, WI 54701-2635
Phone
(715) 598-1829
NPI assigned
Apr 28, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 5527-12 WI Primary

Addresses

Primary practice location

4210 Southtowne Drive
Eau Claire, WI 54701-2635

Mailing address

4210 Southtowne Drive
Eau Claire, WI 54701-2635
Phone (715) 598-1829

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220902002259 WI Practitioner - Chiropractic 2769866169 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5527-12WIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Wellness Way Eau Claire LLC Chiropractor CurrentSince Jul 19, 2022 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

4210 Southtowne Dr
Eau Claire, WI 54701
Phone (715) 598-1829

4410 Golf Ter
Ste 120
Eau Claire, WI 54701

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": "1588032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675296000000",
    "number": "1760003974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4210 SOUTHTOWNE DRIVE",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547012635",
            "telephone_number": "715-598-1829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4210 SOUTHTOWNE DRIVE",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547012635",
            "telephone_number": "715-598-1829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEIL",
        "first_name": "JORDAN",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-28",
        "last_updated": "2023-02-02",
        "certification_date": "2023-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "5527-12",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eau Claire, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2023; 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.