Organization Active NPI

Brian D Jenkins Chiropractic Inc

  • Chiropractor
  • Fair Oaks, CA
National Provider Identifier
1154417327
Registry record updated Nov 14, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
BRIAN D JENKINS CHIROPRACTIC INC
Practice address
4136 Pennsylvania Ave
Fair Oaks, CA 95628-7413
Phone
(916) 962-0144
Fax
(916) 965-4129
NPI assigned
Oct 5, 2006
Last updated
Nov 14, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2007

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

Authorized official

Name
Dr. Brian Dee Jenkins, DCNPI 1770597312
Title
President
Phone
(916) 962-0144

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

4136 Pennsylvania Ave
Fair Oaks, CA 95628-7413

Mailing address

PO Box 126
Folsom, CA 95763-0126
Phone (916) 962-0144

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071031000575 CA Part B Supplier - Clinic/Group Practice 5496842833 Receives reassigned benefits from 1 practitioner
Practice locations: Fair Oaks, CA

National Provider Directory

National Provider Directory

Locations

4990 Hillsdale Cir
Ste 200
El Dorado Hills, CA 95762
Phone (916) 962-0144

4136 Pennsylvania Ave
Fair Oaks, CA 95628
Phone (916) 962-0144

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194998400000",
    "number": "1154417327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 126",
            "city": "FOLSOM",
            "state": "CA",
            "postal_code": "957630126",
            "telephone_number": "916-962-0144",
            "fax_number": "916-965-4129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4136 PENNSYLVANIA AVE",
            "city": "FAIR OAKS",
            "state": "CA",
            "postal_code": "956287413",
            "telephone_number": "916-962-0144",
            "fax_number": "916-965-4129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIAN D JENKINS CHIROPRACTIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-05",
        "last_updated": "2007-11-14",
        "status": "A",
        "authorized_official_last_name": "JENKINS",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "DEE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "916-962-0144",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fair Oaks, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.