Jacob John Fanders, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

01-05359 Issued in KS

Practice address

12643 Metcalf Ave
Overland Park, KS 66213-1317

Phone

(913) 643-1771

NPI assigned

Oct 21, 2010

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 KS

Enrollment records 1

Specialty

Chiropractic

Education

Palmer College Chiropractic - Davenport, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Advanced Sports and Family Chiropractic, LLCGroup PAC ID 7517036023, 17 clinicians

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 and National Provider Directory roles.

• Advanced Sports and Family Chiropractic, LLC

  • Chiropractor
  • Overland Park, KS
  • NPI 1376710293
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1287619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532217600000",
    "number": "1982904140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18800 W 164TH TER",
            "city": "OLATHE",
            "state": "KS",
            "postal_code": "660629044",
            "telephone_number": "402-480-3772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12643 METCALF AVE",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662131317",
            "telephone_number": "913-643-1771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FANDERS",
        "first_name": "JACOB",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-10-21",
        "last_updated": "2018-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "KS",
            "license": "01-05359",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Family Health Center, PA
• Family Health Group, Inc
• Family Health Medical Group of Overland Park, LLC
• Tyler Fancher, PA-C
• Whitney Blaire Fancher, M.D.
• Martha Sue Fanning, M.D.
• Stephen Fanous
• Kimberly A Farag, LPC
• Ghina Fares
• Chelsea Lynn Farmer, LMSW

• Chiropractor in Overland Park, KS
• Providers in Overland Park, KS by specialty
• Chiropractor in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2018; 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.