Kylie Neiderhiser Jeffrey, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

DC009749 Issued in PA

Practice address

1611 Columbia Blvd
Bloomsburg, PA 17815-8862

Phone

(570) 389-1901

Fax

(570) 389-0469

NPI assigned

Jan 30, 2007

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

Other names 1

• Kylie Neiderhiser Professional name

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Specialty

Chiropractic

Education

Palmer College Chiropractic - Davenport, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629158400000",
    "number": "1063559102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1611 COLUMBIA BLVD",
            "city": "BLOOMSBURG",
            "state": "PA",
            "postal_code": "178158862",
            "telephone_number": "570-389-1901",
            "fax_number": "570-389-0469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1611 COLUMBIA BLVD",
            "city": "BLOOMSBURG",
            "state": "PA",
            "postal_code": "178158862",
            "telephone_number": "570-389-1901",
            "fax_number": "570-389-0469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEFFREY",
        "first_name": "KYLIE",
        "middle_name": "NEIDERHISER",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-30",
        "last_updated": "2021-08-17",
        "certification_date": "2021-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "PA",
            "license": "DC009749",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1019225790001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KYLIE",
            "last_name": "NEIDERHISER",
            "credential": "DC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.