Tackett Chiropractic, P.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

X008214 Issued in NY

Legal business name

TACKETT CHIROPRACTIC, P.C.

Practice address

19 Homer Ave
Queensbury, NY 12804-2039

Phone

(518) 798-4322

Fax

(518) 743-8686

NPI assigned

Aug 3, 2006

Organization subpart

No

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

Authorized official

Name

Dr. William Bernard Tackett, D.C.NPI 1760457519

Title

Pres/Owner

Phone

(518) 798-4322

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Interoperability endpoints

• Direct secure messaging: wtacke@tcp0006.direct.chirotouch.md

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• William B Tackett, DC

  • Chiropractor
  • Queensbury, NY
  • NPI 1760457519
  Medicare reassignment Care Compare group Authorized official
• Ellen Nichols, D.C.

  • Chiropractor
  • Queensbury, NY
  • NPI 1669669875
  Medicare reassignment Care Compare group NPD
• Jonathan C Gerber, D.C.

  • Chiropractor
  • Queensbury, NY
  • NPI 1457326902
  NPD (past)
• Edward Thomas Kuntz Jr., L.AC.

  • Acupuncturist
  • Queensbury, NY
  • NPI 1629262431
  NPD (past)
• Kimberly Kay Lockhart, D.C.

  • Chiropractor
  • Queensbury, NY
  • NPI 1265408157
  NPD (past)
• Randall Scott Lockhart, DC

  • Chiropractor
  • Queensbury, NY
  • NPI 1730282328
  NPD (past)
• Lori Millis, PH.D.

  • Clinical Psychologist
  • Queensbury, NY
  • NPI 1467427070
  NPD (past)

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

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1083622336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 HOMER AVE",
            "city": "QUEENSBURY",
            "state": "NY",
            "postal_code": "128042039",
            "telephone_number": "518-798-4322",
            "fax_number": "518-743-8686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 HOMER AVE",
            "city": "QUEENSBURY",
            "state": "NY",
            "postal_code": "128042039",
            "telephone_number": "518-798-4322",
            "fax_number": "518-743-8686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TACKETT CHIROPRACTIC, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "TACKETT",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "BERNARD",
        "authorized_official_title_or_position": "PRES/OWNER",
        "authorized_official_telephone_number": "518-798-4322",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X008214",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CDPHP",
            "identifier": "8248",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Janet Susan Stutzman, TSHH
• Lauren Sullivan, PMHNP
• Summit Imaging Corporation
• Support-Link, Inc.
• Adam Swenson
• William B Tackett, DC
• Henry T Tan, MD
• Deborah Lynn Teppo, LCSW-R
• The Glen at Hiland Meadows
• The Golub Corporation

• Chiropractor in Queensbury, NY
• Providers in Queensbury, NY by specialty
• Chiropractor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.