Individual provider Active NPI

Jay D Rohleder, DC, DACNB

  • Chiropractor
  • Evansville, IN
National Provider Identifier
1821066846
Registry record updated Nov 4, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
08001354 Issued in IN
Practice address
958 S Kenmore Drive
Evansville, IN 47714-7513
Phone
(812) 477-5003
Fax
(812) 479-8229
NPI assigned
Mar 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 08001354 IN Primary

Addresses

Primary practice location

958 S Kenmore Drive
Evansville, IN 47714-7513

Mailing address

958 S Kenmore Drive
Evansville, IN 47714-7513
Phone (812) 477-5003

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100310000440 IN Practitioner - Chiropractic 1456437136 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 1991
Medicare assignment
May accept Medicare assignment
Group practices
Evansville Rehabilitation PCGroup PAC ID 0143219030, 3 clinicians

Practice addresses (Care Compare)

120 N Fulton Ave
Suite B Tristate Functional Wellness
Evansville, IN 47710-1002
Phone (812) 303-0369

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
08001354INMDChiropractor

Organizations & group practices 1

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": "1141776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1257292800000",
    "number": "1821066846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "958 S KENMORE DRIVE",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477147513",
            "telephone_number": "812-477-5003",
            "fax_number": "812-479-8229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "958 S KENMORE DRIVE",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477147513",
            "telephone_number": "812-477-5003",
            "fax_number": "812-479-8229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROHLEDER",
        "first_name": "JAY",
        "middle_name": "D",
        "credential": "DC, DACNB",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-08",
        "last_updated": "2009-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IN",
            "license": "08001354",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evansville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2009; 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.