Individual provider Active NPI

Jennifer J. Bak, D.C., P.C.

  • Chiropractor
  • Wakefield, MA
National Provider Identifier
1215060728
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2125 Issued in MA
Practice address
1 W Water St
Suite 207
Wakefield, MA 01880-2907
Phone
(781) 224-0010
Fax
(781) 224-0147
NPI assigned
Mar 13, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2125 MA Primary

Addresses

Primary practice location

1 W Water St
Suite 207
Wakefield, MA 01880-2907

Mailing address

1 W Water St
Suite 207
Wakefield, MA 01880-2907
Phone (781) 224-0010

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)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
2125MAMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
New Beginnings Family Chiropractic Center LLC PastSince Jan 18, 2014 Accepting new patients

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": "1173744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1215060728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 W WATER ST",
            "address_2": "SUITE 207",
            "city": "WAKEFIELD",
            "state": "MA",
            "postal_code": "018802907",
            "telephone_number": "781-224-0010",
            "fax_number": "781-224-0147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 W WATER ST",
            "address_2": "SUITE 207",
            "city": "WAKEFIELD",
            "state": "MA",
            "postal_code": "018802907",
            "telephone_number": "781-224-0010",
            "fax_number": "781-224-0147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAK",
        "first_name": "JENNIFER",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "D.C., P.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MA",
            "license": "2125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wakefield, MA

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.

Verify at the official NPI Registry.