Individual provider Active NPI

Carson Jenkinson, DC

  • Chiropractor
  • Union City, IN
National Provider Identifier
1962871095
Registry record updated Mar 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
08002865A Issued in IN
Practice address
230 N Columbia St
Union City, IN 47390-1432
Phone
(765) 748-2389
NPI assigned
Sep 18, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 5473 KY
Chiropractor 111N00000X 08002865A IN Primary

Addresses

Primary practice location

230 N Columbia St
Union City, IN 47390-1432

Mailing address

3441 Lebanon Pike
Ste 117
Hermitage, TN 37076-2000
Phone (615) 871-9000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160406000716 TN Practitioner - Chiropractic 1658679790 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3441 Lebanon Pike
Suite 117
Hermitage, TN 37076-2000
Phone (615) 871-9000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2905TNMDMental Health Counselor
08002865AINMDChiropractor
5473KYMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Hermitage Chiropractic and Rehabilitation PLLC Chiropractor CurrentSince Feb 23, 2016 Accepting new patients

Locations

3441 Lebanon Pike
Ste 117
Hermitage, TN 37076
Phone (615) 871-9000

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1442534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458691200000",
    "number": "1962871095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3441 LEBANON PIKE",
            "address_2": "STE 117",
            "city": "HERMITAGE",
            "state": "TN",
            "postal_code": "370762000",
            "telephone_number": "615-871-9000",
            "fax_number": "615-871-9018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 N COLUMBIA ST",
            "city": "UNION CITY",
            "state": "IN",
            "postal_code": "473901432",
            "telephone_number": "765-748-2389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENKINSON",
        "first_name": "CARSON",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-09-18",
        "last_updated": "2016-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "KY",
            "license": "5473",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IN",
            "license": "08002865A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Union City, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2016; 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.