Individual provider Active NPI

Jeffrey S Slocum, D.C.

  • Chiropractor
  • Brunswick, ME
National Provider Identifier
1104815224
Registry record updated May 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CR912 Issued in ME
Practice address
26 Bath Rd
Suite #1
Brunswick, ME 04011-2618
Phone
(207) 725-4222
Fax
(207) 319-7046
NPI assigned
Oct 20, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 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 CR912 ME Primary

Addresses

Primary practice location

26 Bath Rd
Suite #1
Brunswick, ME 04011-2618

Mailing address

26 Bath Rd
Suite #1
Brunswick, ME 04011-2618
Phone (207) 725-4222

Other identifiers 6

IdentifierTypeStateIssuer
132180000MedicaidME
M21506OtherMECIGNA
2243348OtherMEAETNA HMO
034535OtherMEBCBS
M24165OtherMEHEALTHSOURCE
MGD920OtherMEHARVARD PILGRIM

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

State licenses

LicenseStateTypeSpecialty
CR912MEMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Holland Chiropractic Center Chiropractor PastSince Apr 30, 2003 Accepting new patients
Holly Johantgen Brown, PA Past Accepting new patients
Glenn J. Flaming MPT Past Accepting new patients
Slocum Family Chiropractic PA Chiropractor Past Accepting new patients

Organizations & group practices 4

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": "1129766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1305763200000",
    "number": "1104815224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 BATH RD",
            "address_2": "SUITE #1",
            "city": "BRUNSWICK",
            "state": "ME",
            "postal_code": "040112618",
            "telephone_number": "207-725-4222",
            "fax_number": "207-319-7046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26 BATH RD",
            "address_2": "SUITE #1",
            "city": "BRUNSWICK",
            "state": "ME",
            "postal_code": "040112618",
            "telephone_number": "207-725-4222",
            "fax_number": "207-319-7046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SLOCUM",
        "first_name": "JEFFREY",
        "middle_name": "S",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-20",
        "last_updated": "2011-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "ME",
            "license": "CR912",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "132180000",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "M21506",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO",
            "identifier": "2243348",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "034535",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHSOURCE",
            "identifier": "M24165",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM",
            "identifier": "MGD920",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brunswick, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.