Active NPI
Eric Paul Sidmore, D.C.
- Chiropractor
- Wakefield, MA
National Provider Identifier
1609901511
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 1620
- Practice address
- 684 Main St
Wakefield, MA 01880-5207 - Phone
- (781) 224-1920
- NPI assigned
- Feb 22, 2007
- 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 |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 1620 | MA | Primary |
Addresses
Primary practice location
684 Main St
Wakefield, MA 01880-5207
Mailing address
684 Main St
Wakefield, MA 01880-5207
Phone (781) 224-1920
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20060424000465 | MA | Practitioner - Chiropractic | 6002826807 | Practice locations: Wakefield, MA |
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Palmer College Chiropractic - Davenport, 1991
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
684 Main St
Wakefield, MA 01880-5207
Phone (781) 224-1920
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1620 | MA | MD | Podiatrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172102400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1609901511",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "684 MAIN ST",
"city": "WAKEFIELD",
"state": "MA",
"postal_code": "018805207",
"telephone_number": "781-224-1920"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "684 MAIN ST",
"city": "WAKEFIELD",
"state": "MA",
"postal_code": "018805207",
"telephone_number": "781-224-1920"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SIDMORE",
"first_name": "ERIC",
"middle_name": "PAUL",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-02-22",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "MA",
"license": "1620",
"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.
- 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.