Derek Pinkham, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CR2292 Issued in ME

Practice address

24 Church St
Ellsworth, ME 04605-1913

Phone

(207) 667-5432

Fax

(207) 667-5435

NPI assigned

Jul 3, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ME

Enrollment records 1

Specialty

Chiropractic

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Life Source Family Chiropractic LLCGroup PAC ID 6901114487, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northern Light Maine Coast Hospital Hospital, Ellsworth, ME, CCN 200050

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Life Source Family Chiropractic LLC

  • Chiropractor
  • Ellsworth, ME
  • NPI 1912380205
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Maine Coast Regional Health Facilities

  dba Northern Light Maine Coast Hospital

  • General Acute Care Hospital
  • Ellsworth, ME
  • NPI 1740249739
  Care Compare affiliation

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

{
    "created_epoch": "1435881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435881600000",
    "number": "1578946869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 CHURCH ST",
            "city": "ELLSWORTH",
            "state": "ME",
            "postal_code": "046051913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 CHURCH ST",
            "city": "ELLSWORTH",
            "state": "ME",
            "postal_code": "046051913",
            "telephone_number": "207-667-5432",
            "fax_number": "207-667-5435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PINKHAM",
        "first_name": "DEREK",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-07-03",
        "last_updated": "2015-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "ME",
            "license": "CR2292",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Phoenix Care Group LLC
• Emily Megan Picard, PMHNP-BC
• Margaret Pierce, CF-SLP
• Sara Pierce, PT
• Frank Burton Pierson II
• Megan M Pinkham, D.C.
• Robert L Pinsky, MD
• Joan Piskura, CADC
• Susan Polyot, LADC, CCS
• Debra Lynn Porter, CNM

• Chiropractor in Ellsworth, ME
• Providers in Ellsworth, ME by specialty
• Chiropractor in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2015; 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.