Organization Active NPI

O'Connor Chiropractic PC

  • Chiropractor
  • Hicksville, NY
National Provider Identifier
1104218684
Registry record updated Feb 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
X009220 Issued in NY
Legal business name
O'CONNOR CHIROPRACTIC PC
Practice address
125 Jerusalem Ave
Hicksville, NY 11801-4905
Phone
(516) 935-3555
Fax
(516) 935-1225
NPI assigned
Feb 20, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2015

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

Authorized official

Name
Kimberly O'Connor, D.C.NPI 1942394465
Title
Chiropractor
Phone
(516) 935-3555

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
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X X009220 NY Primary

Addresses

Primary practice location

125 Jerusalem Ave
Hicksville, NY 11801-4905

Mailing address

125 Jerusalem Ave
Hicksville, NY 11801-4905
Phone (516) 935-3555

Other names 1

  • Platinum Chiropractic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20151015000958 NY Part B Supplier - Clinic/Group Practice 4587973474 Receives reassigned benefits from 1 practitioner
Practice locations: Hicksville, 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": "1424390400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1424390400000",
    "number": "1104218684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 JERUSALEM AVE",
            "city": "HICKSVILLE",
            "state": "NY",
            "postal_code": "118014905",
            "telephone_number": "516-935-3555",
            "fax_number": "516-935-1225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 JERUSALEM AVE",
            "city": "HICKSVILLE",
            "state": "NY",
            "postal_code": "118014905",
            "telephone_number": "516-935-3555",
            "fax_number": "516-935-1225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "O'CONNOR CHIROPRACTIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-20",
        "last_updated": "2015-02-20",
        "status": "A",
        "authorized_official_last_name": "O'CONNOR",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "516-935-3555",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X009220",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Platinum Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hicksville, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2015; 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.