Carson Samuel Jordan I, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

1394 Issued in MS

Practice address

1725 Central Ave W
Wiggins, MS 39577-2434

Phone

(601) 928-9095

Fax

(601) 928-9383

NPI assigned

Apr 11, 2024

Last updated

Apr 11, 2024By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

Specialty

Chiropractic

Education

Life Chiropractic College, 2024

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Stanley S. Jordan, D.C.

  • Chiropractor
  • Wiggins, MS
  • NPI 1932283546
  Medicare reassignment

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

{
    "created_epoch": "1712793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712793600000",
    "number": "1831942416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1725 CENTRAL AVE W",
            "city": "WIGGINS",
            "state": "MS",
            "postal_code": "395772434",
            "telephone_number": "601-928-9095",
            "fax_number": "601-928-9383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1725 CENTRAL AVE W",
            "city": "WIGGINS",
            "state": "MS",
            "postal_code": "395772434",
            "telephone_number": "601-928-9095",
            "fax_number": "601-928-9383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "CARSON",
        "middle_name": "SAMUEL",
        "name_prefix": "Dr.",
        "name_suffix": "I",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-04-11",
        "last_updated": "2024-04-11",
        "certification_date": "2024-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MS",
            "license": "1394",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maranda L Husley, FNP-C
• Nicole Hymel, LPC, RN
• Amber Johnson, DPT
• Sanether Johnson
• Jordan Chiropractic, P.a.
• Stanley S. Jordan, D.C.
• Kare-in-Home Hospice, LLC (VitalCaring Group)
• Candace Kemp
• Ashton Hermetz Kramer, OT
• Christine L Ladner, FNP

• Chiropractor in Wiggins, MS
• Providers in Wiggins, MS by specialty
• Chiropractor in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2024; 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.