Individual provider Active NPI

George Charles Joachim, DC

  • Chiropractor
  • Fort Wayne, IN
National Provider Identifier
1003854290
Registry record updated Sep 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
08001678A Issued in IN
Practice address
Aaron Chiropractic Clinic
3476 Stellhorn Rd.
Fort Wayne, IN 46815
Phone
(260) 492-8811
Fax
(260) 492-0073
NPI assigned
Jun 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 08001678A IN Primary

Addresses

Primary practice location

Aaron Chiropractic Clinic
3476 Stellhorn Rd.
Fort Wayne, IN 46815

Mailing address

Aaron Chiropractic Clinic
3476 Stellhorn Rd.
Fort Wayne, IN 46815
Phone (260) 492-8811

Other identifiers 3

IdentifierTypeStateIssuer
200092760AMedicaidIN
35-2036658OtherINGROUP # (TAX ID)
000000092692OtherINBC BS ID #

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090923000243 IN Practitioner - Chiropractic 1658427299 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
National University of Arts and Sciences, Medical Department, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bink IncGroup PAC ID 4789730326, 3 clinicians

Practice addresses (Care Compare)

3476 Stellhorn Rd
Fort Wayne, IN 46815-4630
Phone (260) 492-8811

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
08001678AINMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Bink Inc Chiropractor CurrentSince Aug 5, 2009 Accepting new patients

Locations

3476 Stellhorn Rd
Fort Wayne, IN 46815
Phone (219) 492-8811

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": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316390400000",
    "number": "1003854290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "AARON CHIROPRACTIC CLINIC",
            "address_2": "3476 STELLHORN RD.",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "46815",
            "telephone_number": "260-492-8811",
            "fax_number": "260-492-0073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "AARON CHIROPRACTIC CLINIC",
            "address_2": "3476 STELLHORN RD.",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "46815",
            "telephone_number": "260-492-8811",
            "fax_number": "260-492-0073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOACHIM",
        "first_name": "GEORGE",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-02",
        "last_updated": "2011-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IN",
            "license": "08001678A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200092760A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP # (TAX ID)",
            "identifier": "35-2036658",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC BS ID #",
            "identifier": "000000092692",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2011; 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.