Individual provider Active NPI

Jessica Carrick, DC

  • Chiropractor
  • Lockport, NY
National Provider Identifier
1245952357
Registry record updated Dec 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
013783 Issued in NY
Practice address
6612 Lincoln Ave
Lockport, NY 14094-6109
Phone
(716) 433-1322
NPI assigned
Sep 15, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 15010 TX
Chiropractor 111N00000X 013783 NY Primary

Addresses

Primary practice location

6612 Lincoln Ave
Lockport, NY 14094-6109

Mailing address

6580 Bianchi LN
Clarence, NY 14031-1084
Phone (716) 289-4475

Other practice location 1

4440 Shimerville Rd
Clarence, NY 14031-1808
Phone (716) 633-2036

Other names 1

  • Jessica Lewis Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240111001138 NY Practitioner - Chiropractic 3476904764 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
August J Domenico Jr DCGroup PAC ID 2264456102, 4 clinicians
David J Lewis DC PCGroup PAC ID 6709038078, 3 clinicians

Practice addresses (Care Compare)

6612 Lincoln Ave
Lockport, NY 14094-6109
Phone (716) 433-1322

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
15010TXMDProfessional Counselor
013783NYMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
August J. Domenico Jr. DC Chiropractor CurrentSince Dec 30, 2023 Accepting new patients
David J. Lewis DC PC Chiropractor CurrentSince Dec 30, 2023 Accepting new patients
Zimmer Chiropractic Clinic, Inc Chiropractor PastSince Sep 1, 2022 Accepting new patients

Locations

4440 Shimerville Rd
Clarence, NY 14031
Phone (716) 633-2036

6612 Lincoln Ave
Lockport, NY 14094
Phone (716) 243-6154

Organizations & group practices 3

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": "1663200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701648000000",
    "number": "1245952357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6580 BIANCHI LN",
            "city": "CLARENCE",
            "state": "NY",
            "postal_code": "140311084",
            "telephone_number": "716-289-4475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6612 LINCOLN AVE",
            "city": "LOCKPORT",
            "state": "NY",
            "postal_code": "140946109",
            "telephone_number": "716-433-1322"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4440 Shimerville Rd",
            "address_purpose": "LOCATION",
            "city": "Clarence",
            "state": "NY",
            "postal_code": "140311808",
            "country_code": "US",
            "telephone_number": "716-633-2036",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARRICK",
        "first_name": "JESSICA",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-15",
        "last_updated": "2023-12-04",
        "certification_date": "2023-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "15010",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "013783",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "LEWIS",
            "credential": "DC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lockport, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2023; 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.