Individual provider Active NPI

Richard J Herbold, D.C.

  • Chiropractor
  • Clifton Park, NY
National Provider Identifier
1013919869
Registry record updated Jan 20, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
02731-0 Issued in NY
Practice address
140 Lapp Rd
Clifton Park, NY 12065-6018
Phone
(518) 371-6431
NPI assigned
Aug 11, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 20, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 02731-0 NY Primary

Addresses

Primary practice location

140 Lapp Rd
Clifton Park, NY 12065-6018

Mailing address

45 Geiser Rd
Wynantskill, NY 12198-2502

Other identifiers 2

IdentifierTypeStateIssuer
10015608OtherNYCDPHP
02731-0OtherNYLICENSE NUMBER

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
02731-0NYMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1123718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1232409600000",
    "number": "1013919869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 GEISER RD",
            "city": "WYNANTSKILL",
            "state": "NY",
            "postal_code": "121982502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 LAPP RD",
            "city": "CLIFTON PARK",
            "state": "NY",
            "postal_code": "120656018",
            "telephone_number": "518-371-6431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERBOLD",
        "first_name": "RICHARD",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-11",
        "last_updated": "2009-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "02731-0",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CDPHP",
            "identifier": "10015608",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "02731-0",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clifton Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2009; 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.