Active NPI
Joel Aaron Fernald, DC
- Chiropractor
- South China, ME
National Provider Identifier
1053478552
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- CR1592
- Practice address
- 16 Jonesbrook Crossing
South China, ME 04358 - Phone
- (207) 445-4663
- Fax
- (866) 573-8515
- NPI assigned
- Jan 3, 2007
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | CR1592 | ME | Primary |
Addresses
Primary practice location
16 Jonesbrook Crossing
South China, ME 04358
Mailing address
PO Box 86
16 Jonesbrook Crossing
South China, ME 04358
Phone (207) 445-4663
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100016 | Other | ME | ANTHEM |
| P00310456 | Other | RAILROAD MEDICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167782400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1053478552",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 86",
"address_2": "16 JONESBROOK CROSSING",
"city": "SOUTH CHINA",
"state": "ME",
"postal_code": "04358",
"telephone_number": "207-445-4663",
"fax_number": "866-573-8515"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16 JONESBROOK CROSSING",
"city": "SOUTH CHINA",
"state": "ME",
"postal_code": "04358",
"telephone_number": "207-445-4663",
"fax_number": "866-573-8515"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FERNALD",
"first_name": "JOEL",
"middle_name": "AARON",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-03",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "ME",
"license": "CR1592",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "100016",
"state": "ME"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00310456",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in South China, ME
Sources for this page
- 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.