Individual provider Active NPI

Joseph Fraser Gilmore

  • Chiropractor
  • Dedham, MA
National Provider Identifier
1093941338
Registry record updated Nov 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3306 Issued in MA
Practice address
145 Fairbanks Rd
Dedham, MA 02026-4938
Phone
(603) 819-9356
NPI assigned
Jun 1, 2009
Last updated
Nov 8, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3306 MA Primary

Addresses

Primary practice location

145 Fairbanks Rd
Dedham, MA 02026-4938

Mailing address

145 Fairbanks Rd
Dedham, MA 02026-4938
Phone (603) 819-9356

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211021002743 MA Practitioner - Chiropractic 5193113298 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
New York Chiropractic College, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

18 Station Ave
Suite a
Newton Highlands, MA 02461-1222
Phone (617) 244-3330

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3306MAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Bay State Physical Therapy of Randolph Inc Chiropractor CurrentSince Dec 31, 2021 Accepting new patients
Bay State Physical Therapy of Randolph Inc Chiropractor Past Accepting new patients

Locations

18 Station Ave
Ste A
Newton Highlands, MA 02461
Phone (617) 244-3330

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1243814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636329600000",
    "number": "1093941338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 FAIRBANKS RD",
            "city": "DEDHAM",
            "state": "MA",
            "postal_code": "020264938",
            "telephone_number": "603-819-9356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 FAIRBANKS RD",
            "city": "DEDHAM",
            "state": "MA",
            "postal_code": "020264938",
            "telephone_number": "603-819-9356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILMORE",
        "first_name": "JOSEPH",
        "middle_name": "FRASER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-01",
        "last_updated": "2021-11-08",
        "certification_date": "2021-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MA",
            "license": "3306",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dedham, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2021; 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.