Individual provider Active NPI

Karen Lynn De Brine, D.C.

  • Chiropractor
  • Victor, NY
National Provider Identifier
1063455012
Registry record updated Oct 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
X005685-1 Issued in NY
Practice address
7588 Main Street Fishers Road
Victor, NY 14564-9741
Phone
(585) 398-7620
Fax
(585) 396-5451
NPI assigned
Jun 14, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 28, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X X005685-1 NY Primary

Addresses

Primary practice location

7588 Main Street Fishers Road
Victor, NY 14564-9741

Mailing address

7588 Main Street Fishers Road
Victor, NY 14564-9741
Phone (585) 398-7620

Other identifiers 1

IdentifierTypeStateIssuer
04518278MedicaidNY

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
X005685-1NYMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Dargout Family Chiropractic, LLC Chiropractor Past Accepting new patients

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": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572220800000",
    "number": "1063455012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7588 MAIN STREET FISHERS ROAD",
            "city": "VICTOR",
            "state": "NY",
            "postal_code": "145649741",
            "telephone_number": "585-398-7620",
            "fax_number": "585-396-5451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7588 MAIN STREET FISHERS ROAD",
            "city": "VICTOR",
            "state": "NY",
            "postal_code": "145649741",
            "telephone_number": "585-398-7620",
            "fax_number": "585-396-5451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE BRINE",
        "first_name": "KAREN",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-14",
        "last_updated": "2019-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X005685-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04518278",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Victor, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2019; 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.