John M Jordan, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

2413 Issued in WI

Practice address

438 N Water St
Black River Falls, WI 54615-1005

Phone

(171) 528-4555

Fax

(171) 528-4916

NPI assigned

Feb 20, 2007

Last updated

Jul 8, 2007By 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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Specialty

Chiropractic

Education

Palmer College Chiropractic - West Sunnyvale, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Jordan Chiropractic Clinic S.C.Group PAC ID 1153502117, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Jessen Family Chiropractic Clinic Inc

  • Chiropractor
  • Black River Falls, WI
  • NPI 1114099462
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1871638718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "438 N WATER ST",
            "city": "BLACK RIVER FALLS",
            "state": "WI",
            "postal_code": "546151005",
            "telephone_number": "171-528-4555",
            "fax_number": "171-528-4916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "438 N WATER ST",
            "city": "BLACK RIVER FALLS",
            "state": "WI",
            "postal_code": "546151005",
            "telephone_number": "171-528-4555",
            "fax_number": "171-528-4916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "JOHN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "2413",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38992500",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Heather Jerzak, RD, CD
• Jessen Family Chiropractic Clinic Inc
• Elizabeth Johnson, RN, BSN, LSN
• Lisa Dawn Johnson
• Mary Jane Jones, RPH
• Marie L Jordan, DC
• David B Kellen, M.D.
• Kathleen M Kett, CNM
• Jerome C Kitowski, M.D.
• Nicholas Jerome Kitowski, M.D.

• Chiropractor in Black River Falls, WI
• Providers in Black River Falls, WI by specialty
• Chiropractor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.