Active NPI
Dermot Connole Jinks, D.C.
- Single Specialty Group
- Peabody, MA
National Provider Identifier
1528161817
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Single Specialty Group
- License
- X011848
- Practice address
- 49 Central St
Suite 1a
Peabody, MA 01960-4375 - Phone
- (978) 531-0202
- Fax
- (978) 532-7076
- NPI assigned
- Sep 5, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Single Specialty Group | 193400000X | X011848 | NY | Primary |
Addresses
Primary practice location
49 Central St
Suite 1a
Peabody, MA 01960-4375
Mailing address
402 Rowland St
Ballston Spa, NY 12020-2684
Phone (518) 363-0202
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| Y36302 | Other | MA | BLUE CROSS BLUE SHIELD # |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Palmer College Chiropractic - West Sunnyvale, 1993
- Medicare assignment
- May accept Medicare assignment
- Group practices
Practice addresses (Care Compare)
402 Rowland St
Ballston Spa, NY 12020-2684
Phone (518) 363-0202
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 011848 | NY | MD | Mental Health Counselor |
| X011848 | NY | MD | Single Specialty Group |
| 1777 | MA | MD | Occupational Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Adirondack Advanced Chiropractic, PC | Single Specialty | Current | Accepting new patients |
| Adio Chiropractic, PLLC | Single Specialty | Past | Accepting new patients |
| Peabody Family Chiropractic, Inc. | Single Specialty | Past | Accepting new patients |
Locations
402 Rowland St
Ballston Spa, NY 12020
Phone (518) 363-0202
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.
-
dba AAC Family Wellness Centers
- Chiropractor
- Schenectady, NY
- NPI 1750674198
Single Specialty
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157414400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1477440000000",
"number": "1528161817",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "402 ROWLAND ST",
"city": "BALLSTON SPA",
"state": "NY",
"postal_code": "120202684",
"telephone_number": "518-363-0202",
"fax_number": "518-363-0711"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "49 CENTRAL ST",
"address_2": "SUITE 1A",
"city": "PEABODY",
"state": "MA",
"postal_code": "019604375",
"telephone_number": "978-531-0202",
"fax_number": "978-532-7076"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JINKS",
"first_name": "DERMOT",
"middle_name": "CONNOLE",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-09-05",
"last_updated": "2016-10-26",
"status": "A"
},
"taxonomies": [
{
"code": "193400000X",
"taxonomy_group": "",
"desc": "Single Specialty",
"state": "NY",
"license": "X011848",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD #",
"identifier": "Y36302",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Peabody, MA
- Jaybell Health System'S LLC
- Jennifer Wood LMHC LLC
- Jewish Rehabilitation Center (Shapiro Rudolph Adult Day Care)
- Jewish Rehabilitation Center for Aged of the North Shore, Inc. (Jeffrey & Susan Brudnick Center for Living)
- Zainab Oyenike Jimada, DNP
- Ashiana Jivraj, DMD
- JK Smiles PLLC
- John a. Pavlo DMD PC
- John J Weiter, MD, PC (Retina Consultants of Greater Boston, Inc.)
- John J. Weiter, M.D., PH.D.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2016; 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.