Jake Eric Bordelon, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

DC1328 Issued in LA

Practice address

430 Corporate Dr
Houma, LA 70360-2461

Phone

(985) 873-8586

Fax

(985) 873-8565

NPI assigned

Jun 7, 2006

Last updated

Apr 12, 2016By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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 LA

Enrollment records 1

Specialty

Chiropractic

Education

Other, 2002

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Houma Pha, LLC

  dba Houma Thibodaux Spine and Rehabilitation, LLC

  • Chiropractor
  • Houma, LA
  • NPI 1033260344
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460419200000",
    "number": "1912947052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "430 CORPORATE DR",
            "city": "HOUMA",
            "state": "LA",
            "postal_code": "703602461",
            "telephone_number": "985-873-8586",
            "fax_number": "985-873-8565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 CORPORATE DR",
            "city": "HOUMA",
            "state": "LA",
            "postal_code": "703602461",
            "telephone_number": "985-873-8586",
            "fax_number": "985-873-8565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORDELON",
        "first_name": "JAKE",
        "middle_name": "ERIC",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-07",
        "last_updated": "2016-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "LA",
            "license": "DC1328",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mandi Gaubert Bonvillain, SSP, NCSP, BCBA
• Suzanne C Bonvillain, MSN, APRN, FNP-C
• Titus Boone Jr.
• Cassie Boquet, M.S., PL/SLP, CF/SLP
• Erica Boquet
• Jessica Ann Borne, MD
• Richard I Borne, DDS
• Boudreaux Spine & Joint
• Ashley Boudreaux, M.S., CCC-SLP
• Ashley Marie Boudreaux, LPC

• Chiropractor in Houma, LA
• Providers in Houma, LA by specialty
• Chiropractor in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2016; 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.