Individual provider Active NPI

Kimberly Anne Romaine, D.C.

  • Chiropractor
  • Shirley, NY
National Provider Identifier
1003901083
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
X004616-1 Issued in NY
Practice address
283 William Floyd Pkwy
Shirley, NY 11967-3467
Phone
(631) 281-0966
Fax
(631) 281-0966
NPI assigned
Oct 4, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X X004616-1 NY Primary

Addresses

Primary practice location

283 William Floyd Pkwy
Shirley, NY 11967-3467

Mailing address

283 William Floyd Pkwy
Shirley, NY 11967-3467
Phone (631) 281-0966

Other identifiers 1

IdentifierTypeStateIssuer
CO4616-0OtherNYWORKER'S COMPENSATION #

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
004616NYMDBehavioral Analyst
X004616-1NYMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1003901083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "283 WILLIAM FLOYD PKWY",
            "city": "SHIRLEY",
            "state": "NY",
            "postal_code": "119673467",
            "telephone_number": "631-281-0966",
            "fax_number": "631-281-0966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "283 WILLIAM FLOYD PKWY",
            "city": "SHIRLEY",
            "state": "NY",
            "postal_code": "119673467",
            "telephone_number": "631-281-0966",
            "fax_number": "631-281-0966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROMAINE",
        "first_name": "KIMBERLY",
        "middle_name": "ANNE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X004616-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WORKER'S COMPENSATION #",
            "identifier": "CO4616-0",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shirley, NY

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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.