Individual provider Active NPI

Jordan Mouw, DC

  • Chiropractor
  • Council Bluffs, IA
National Provider Identifier
1962913863
Registry record updated Oct 18, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
089400 Issued in IA
Practice address
20 Power Dr Ste 1
Council Bluffs, IA 51501-7701
Phone
(712) 366-1611
NPI assigned
Oct 18, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 089400 IA Primary

Addresses

Primary practice location

20 Power Dr Ste 1
Council Bluffs, IA 51501-7701

Mailing address

20 Power Dr Ste 1
Council Bluffs, IA 51501-7701
Phone (712) 366-1611

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171215002364 IA Practitioner - Chiropractic 3870851066 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mouw Chiropractic and Spinal Rehabilitation Center PCGroup PAC ID 3173580115, 5 clinicians

Practice addresses (Care Compare)

20 Power Dr
Suite 1
Council Bluffs, IA 51501-7701
Phone (712) 366-1611

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
089400IAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Mouw Chiropractic & Spinal Rehabilitation Center, P.C. Chiropractor CurrentSince Nov 13, 2017 Accepting new patients

Locations

20 Power Dr
Ste 1
Council Bluffs, IA 51501
Phone (712) 366-1611

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": "1508284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508284800000",
    "number": "1962913863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 POWER DR STE 1",
            "city": "COUNCIL BLUFFS",
            "state": "IA",
            "postal_code": "515017701",
            "telephone_number": "712-366-1611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 POWER DR STE 1",
            "city": "COUNCIL BLUFFS",
            "state": "IA",
            "postal_code": "515017701",
            "telephone_number": "712-366-1611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOUW",
        "first_name": "JORDAN",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-10-18",
        "last_updated": "2017-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IA",
            "license": "089400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Council Bluffs, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2017; 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.