Jerry Kosak Chiropractic, Inc.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

DC25538 Issued in CA

Legal business name

JERRY KOSAK CHIROPRACTIC, INC.

Doing business as

Kosak Chiropractic

Practice address

1252 Travis Blvd Ste G
Fairfield, CA 94533-4840

Phone

(707) 426-1111

Fax

(707) 426-2725

NPI assigned

Jun 15, 2007

Last updated

Aug 21, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Sheila M. Perrin

Title

Office Manager

Phone

(707) 426-1111

Specialties & licenses 1

Addresses

Other names 1

• KOSAK CHIROPRACTIC Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Michael Scott Wilson, D.C., QME

  • Chiropractor
  • Fairfield, CA
  • NPI 1710095740
  Medicare reassignment
• Rachel Michelle Howley, DC

  • Chiropractor
  • Vacaville, CA
  • NPI 1649919093
  NPD

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

{
    "created_epoch": "1181865600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1566345600000",
    "number": "1760687271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1252 TRAVIS BLVD STE G",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945334840",
            "telephone_number": "707-426-1111",
            "fax_number": "707-426-2725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1252 TRAVIS BLVD STE G",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945334840",
            "telephone_number": "707-426-1111",
            "fax_number": "707-426-2725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JERRY KOSAK CHIROPRACTIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-15",
        "last_updated": "2019-08-21",
        "status": "A",
        "authorized_official_last_name": "PERRIN",
        "authorized_official_first_name": "SHEILA",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "707-426-1111",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC25538",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "KOSAK CHIROPRACTIC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "KOSAK CHIROPRACTIC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Bethany Elise Jensen
• Georgina Jensen, MD
• Rose C Jensen, MD
• Peter De la Cruz Jereza
• Justin Burton Jergensen, DDS, MS
• Matthew Ryan Jezierski, LMFT
• Wiktor Jeznach
• JHM Nemt
• Martha Jasmine Jimenez Pease
• Bonnie Jimenez

• Chiropractor in Fairfield, CA
• Providers in Fairfield, CA by specialty
• Chiropractor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.