Individual provider Active NPI

Douglas J. Vanvorst, D.C.

  • Rehabilitation Chiropractor
  • Amsterdam, NY
National Provider Identifier
1093891962
Registry record updated Dec 11, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation ChiropractorTaxonomy code 111NR0400X
License
004774-1 Issued in NY
Practice address
5010 State Highway 30
Amsterdam, NY 12010-7532
Phone
(518) 842-2374
NPI assigned
Oct 31, 2006
Last updated
Dec 11, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 11, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Chiropractor 111NR0400X 004774-1 NY Primary

Addresses

Primary practice location

5010 State Highway 30
Amsterdam, NY 12010-7532

Mailing address

402 Union St
Schenectady, NY 12305-1119
Phone (518) 374-7555

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050203000044 NY Practitioner - Chiropractic 6800847237 Practice locations: Amsterdam, NY

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
New York Chiropractic College, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5010 State Hwy 30
Suite 104
Amsterdam, NY 12010-7532

5010 State Hwy 30 104
Amsterdam, NY 12010-7532
Phone (518) 842-2340

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
004774-1NYMDRehabilitation Chiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Bourgeois Family Chiropractic, P.C. 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1162252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197331200000",
    "number": "1093891962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "402 UNION ST",
            "city": "SCHENECTADY",
            "state": "NY",
            "postal_code": "123051119",
            "telephone_number": "518-374-7555",
            "fax_number": "518-374-6898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5010 STATE HIGHWAY 30",
            "city": "AMSTERDAM",
            "state": "NY",
            "postal_code": "120107532",
            "telephone_number": "518-842-2374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANVORST",
        "first_name": "DOUGLAS",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-31",
        "last_updated": "2007-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Rehabilitation",
            "state": "NY",
            "license": "004774-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Amsterdam, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2007; 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.