Organization Active NPI

Shine Chiropractic PLLC

  • Chiropractor
  • Flushing, NY
National Provider Identifier
1053215244
Registry record updated Oct 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
SHINE CHIROPRACTIC PLLC
Practice address
13621 Roosevelt Ave Ste 204
Flushing, NY 11354-5507
Phone
(718) 516-1888
Fax
(718) 516-2888
NPI assigned
Oct 2, 2026
Last updated
Oct 2, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2026

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

Authorized official

Name
Edwin Thompson, DC
Title
Chiropractor
Phone
(718) 516-1888

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X NU Primary

Addresses

Primary practice location

13621 Roosevelt Ave Ste 204
Flushing, NY 11354-5507

Mailing address

13621 Roosevelt Ave Ste 204
Flushing, NY 11354-5507
Phone (718) 516-1888

NPI Registry JSON

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

{
    "created_epoch": "1790899200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1790899200000",
    "number": "1053215244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13621 ROOSEVELT AVE STE 204",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113545507",
            "telephone_number": "718-516-1888",
            "fax_number": "718-516-2888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13621 ROOSEVELT AVE STE 204",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113545507",
            "telephone_number": "718-516-1888",
            "fax_number": "718-516-2888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHINE CHIROPRACTIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-10-02",
        "last_updated": "2026-10-02",
        "certification_date": "2026-10-02",
        "status": "A",
        "authorized_official_last_name": "THOMPSON",
        "authorized_official_first_name": "EDWIN",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "718-516-1888",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.