Organization Active NPI

Tarrytown Chiropractic PLLC

  • Nutrition Chiropractor
  • Tarrytown, NY
National Provider Identifier
1104119080
Registry record updated May 25, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nutrition ChiropractorTaxonomy code 111NN1001X
License
X006879-1 Issued in NY
Legal business name
TARRYTOWN CHIROPRACTIC PLLC
Practice address
102 S Broadway
Tarrytown, NY 10591-4006
Phone
(914) 631-4900
Fax
(914) 332-1362
NPI assigned
May 25, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 25, 2011

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

Authorized official

Name
Dr. Michael Paule, D.C.NPI 1427137561
Title
Owner
Phone
(914) 631-4900

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nutrition ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111NN1001X X006879-1 NY Primary

Addresses

Primary practice location

102 S Broadway
Tarrytown, NY 10591-4006

Mailing address

102 S Broadway
Tarrytown, NY 10591-4006
Phone (914) 631-4900

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110531000466 NY Part B Supplier - Clinic/Group Practice 3779760798 Receives reassigned benefits from 1 practitioner
Practice locations: Tarrytown, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1306281600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1306281600000",
    "number": "1104119080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 S BROADWAY",
            "city": "TARRYTOWN",
            "state": "NY",
            "postal_code": "105914006",
            "telephone_number": "914-631-4900",
            "fax_number": "914-332-1362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 S BROADWAY",
            "city": "TARRYTOWN",
            "state": "NY",
            "postal_code": "105914006",
            "telephone_number": "914-631-4900",
            "fax_number": "914-332-1362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TARRYTOWN CHIROPRACTIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-25",
        "last_updated": "2011-05-25",
        "status": "A",
        "authorized_official_last_name": "PAULE",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "914-631-4900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111NN1001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor, Nutrition",
            "state": "NY",
            "license": "X006879-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tarrytown, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2011; 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.