Organization Active NPI

Slocum Chiropractic PA

  • Chiropractor
  • Brunswick, ME
National Provider Identifier
1821239641
Registry record updated Apr 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CR912 Issued in ME
Legal business name
SLOCUM CHIROPRACTIC PA
Practice address
26 Bath Rd Ste 1
Brunswick, ME 04011-2618
Phone
(207) 725-4222
Fax
(207) 319-7046
NPI assigned
Mar 9, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2012

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

Authorized official

Name
Wendy S Enman
Title
Office Manager
Phone
(207) 725-4222

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 111N00000X CR815 ME
ChiropractorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 111N00000X CR912 ME Primary
ChiropractorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 111N00000X CR2038 ME

Addresses

Primary practice location

26 Bath Rd Ste 1
Brunswick, ME 04011-2618

Mailing address

26 Bath Rd Ste 1
Brunswick, ME 04011-2618
Phone (207) 725-4222

Other identifiers 1

IdentifierTypeStateIssuer
122380000MedicaidME

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091228000373 ME Part B Supplier - Clinic/Group Practice 9638219595 Receives reassigned benefits from 1 practitioner
Practice locations: Brunswick, ME

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1236556800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1334016000000",
    "number": "1821239641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 BATH RD STE 1",
            "city": "BRUNSWICK",
            "state": "ME",
            "postal_code": "040112618",
            "telephone_number": "207-725-4222",
            "fax_number": "207-319-7046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26 BATH RD STE 1",
            "city": "BRUNSWICK",
            "state": "ME",
            "postal_code": "040112618",
            "telephone_number": "207-725-4222",
            "fax_number": "207-319-7046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SLOCUM CHIROPRACTIC PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-09",
        "last_updated": "2012-04-10",
        "status": "A",
        "authorized_official_last_name": "ENMAN",
        "authorized_official_first_name": "WENDY",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "207-725-4222"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "ME",
            "license": "CR815",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "ME",
            "license": "CR912",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "ME",
            "license": "CR2038",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "122380000",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brunswick, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2012; 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.