Kristine M. Nelson, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

DC-4929L Issued in PA

Practice address

413 High St
Waterford, PA 16441-8301

Phone

(814) 796-3535

Fax

(814) 796-3535

NPI assigned

Oct 12, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Bespoke Chiropractic LLC

  dba Chiropractic Works

  • Chiropractor
  • Waterford, PA
  • NPI 1558024661
  NPD (past)

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1003905399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 757",
            "city": "WATERFORD",
            "state": "PA",
            "postal_code": "164410757",
            "telephone_number": "814-796-3535",
            "fax_number": "814-796-3535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "413 HIGH ST",
            "city": "WATERFORD",
            "state": "PA",
            "postal_code": "164418301",
            "telephone_number": "814-796-3535",
            "fax_number": "814-796-3535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "KRISTINE",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "PA",
            "license": "DC-4929L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "725732",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Edward Colton Owens
• Andrew L Pamer, D.C.
• Dinesh Nandlal Patel, DDS
• Luke T Pavkov, D.C.
• Sarah Lynn Peters, LPN

• Chiropractor in Waterford, PA
• Providers in Waterford, PA by specialty
• Chiropractor in Pennsylvania

• 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.