Individual provider Active NPI

James Daniel Kirk, D.C.

  • Chiropractor
  • Downers Grove, IL
National Provider Identifier
1780750356
Registry record updated Aug 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038-010069 Issued in IL
Practice address
6230 Main St
Downers Grove, IL 60516-1908
Phone
(630) 960-9914
Fax
(630) 960-9924
NPI assigned
Nov 27, 2006
Last updated
Aug 27, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038-010069 IL Primary

Addresses

Primary practice location

6230 Main St
Downers Grove, IL 60516-1908

Mailing address

6230 Main St
Downers Grove, IL 60516-1908
Phone (630) 960-9914

Other identifiers 1

IdentifierTypeStateIssuer
2221717OtherILBCBS ID

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040901000510 IL Practitioner - Chiropractic 0749255750 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Concept Care Chiropractic and Wellness Center SCGroup PAC ID 1951453539, 3 clinicians

Practice addresses (Care Compare)

6230 Main St
Downers Grove, IL 60516-1908
Phone (630) 960-9914

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
038-010069ILMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Concept Care Chiropractic and Wellness Center SC Chiropractor CurrentSince Jul 13, 2009 Accepting new patients

Locations

6230 Main St
Downers Grove, IL 60516
Phone (630) 960-9914

6234 Main St
Downers Grove, IL 60516
Phone (630) 435-6461

Organizations & group practices 1

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": "1164585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598486400000",
    "number": "1780750356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6230 MAIN ST",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605161908",
            "telephone_number": "630-960-9914",
            "fax_number": "630-960-9924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6230 MAIN ST",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605161908",
            "telephone_number": "630-960-9914",
            "fax_number": "630-960-9924"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRK",
        "first_name": "JAMES",
        "middle_name": "DANIEL",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-27",
        "last_updated": "2020-08-27",
        "certification_date": "2020-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038-010069",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS ID",
            "identifier": "2221717",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Downers Grove, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2020; 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.