Individual provider Active NPI

Joshua M Fink, D.C., B.S.

  • Chiropractor
  • Dardenne Prairie, MO
National Provider Identifier
1396749875
Registry record updated May 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2002001434 Issued in MO
Practice address
1755 Stump Rd
Dardenne Prairie, MO 63368-6716
Phone
(636) 922-0777
Fax
(636) 922-0833
NPI assigned
Jun 13, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 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 2002001434 MO Primary

Addresses

Primary practice location

1755 Stump Rd
Dardenne Prairie, MO 63368-6716

Mailing address

1755 Stump Rd
Dardenne Prairie, MO 63368-6716
Phone (636) 922-0777

Other practice location 1

5055 Highway N
Ste 210
Saint Charles, MO 63304-8034
Phone (636) 922-0777

Other identifiers 11

IdentifierTypeStateIssuer
170328OtherMOBLUE CROSS BLUE SHIELD
513802OtherMOHEALTHLINK
861060218OtherMOMUTUAL OF OMAHA COMPANIES
861060218OtherMOHUMANA, INC.
861060218OtherMOUNITED HEALTHCARE
3713696OtherMOCARPENTERS HEALTH & WELFARE
DB1222OtherMORAILROAD MEDICARE
568329OtherMOCOVENTRY HEALTH & LIFE INSURANCE COMPANY
86-1060218 003OtherMOWELFARD EDUCATIONAL FUND
861060218OtherMOCMR
861060218OtherMOUNITED HEALTH CARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120208000155 MO Practitioner - Chiropractic 2769581792 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Walton CS-IX IncGroup PAC ID 4688773617, 5 clinicians

Practice addresses (Care Compare)

1755 Stump Rd
Dardenne Prairie, MO 63368-6716
Phone (636) 922-0777

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Bachelor of Science

Practice roles

OrganizationSpecialtyStatusNew patients
Walton CS-IX Inc Chiropractor CurrentSince Jul 3, 2003 Accepting new patients
Primary Care Chiropractic LLC Chiropractor PastSince Jun 1, 2003 Accepting new patients

Locations

1755 Stump Rd
O Fallon, MO 63368
Phone (636) 922-0777

5055 Highway N
Saint Charles, MO 63304
Phone (636) 922-0777

5055 Highway N
Ste 210
Saint Charles, MO 63304
Phone (636) 922-0777

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": "1118620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621468800000",
    "number": "1396749875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1755 STUMP RD",
            "city": "DARDENNE PRAIRIE",
            "state": "MO",
            "postal_code": "633686716",
            "telephone_number": "636-922-0777",
            "fax_number": "636-922-0833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1755 STUMP RD",
            "city": "DARDENNE PRAIRIE",
            "state": "MO",
            "postal_code": "633686716",
            "telephone_number": "636-922-0777",
            "fax_number": "636-922-0833"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5055 Highway N",
            "address_2": "Ste 210",
            "address_purpose": "LOCATION",
            "city": "Saint Charles",
            "state": "MO",
            "postal_code": "633048034",
            "country_code": "US",
            "telephone_number": "636-922-0777",
            "fax_number": "636-922-0833",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FINK",
        "first_name": "JOSHUA",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "D.C., B.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-13",
        "last_updated": "2021-05-20",
        "certification_date": "2021-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "2002001434",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "170328",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "513802",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MUTUAL OF OMAHA COMPANIES",
            "identifier": "861060218",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA, INC.",
            "identifier": "861060218",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "861060218",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARPENTERS HEALTH & WELFARE",
            "identifier": "3713696",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DB1222",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COVENTRY HEALTH & LIFE INSURANCE COMPANY",
            "identifier": "568329",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELFARD EDUCATIONAL FUND",
            "identifier": "86-1060218 003",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CMR",
            "identifier": "861060218",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "861060218",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dardenne Prairie, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 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.