Patenaude Chiropractic LLP
Organization Active NPI Chiropractor · Stillwater, NY
NPI 1114064516 · NPPES record last updated Jun 28, 2013
Key facts
- NPI
- 1114064516
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Chiropractor 111N00000X
- License
- X011154 (NY)
- Legal business name
- PATENAUDE CHIROPRACTIC LLP
- Practice address
- 781 Hudson Ave
Stillwater, NY 12170-0427 - Phone
- (518) 664-4525
- Fax
- (518) 664-1256
- NPI assigned
- Feb 1, 2007
- Organization subpart
- No
Authorized official
- Name
- Dr. Kelli Leigh Patenaude, DC
- Title
- Chiropractor Partner
- Phone
- (518) 664-4525
Practitioners 3
-
Kelli Leigh Patenaude, D.C.
-
Jessica A Davis, MD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20060315000616 | NY | Part B Supplier - Clinic/Group Practice | 8729095773 |
Receives reassigned benefits from 2 practitioners Practice locations: Stillwater, NY |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor |
111N00000X | X011154 | NY | Yes |
Addresses
Primary practice location
781 Hudson Ave
Stillwater, NY 12170-0427
Mailing address
PO Box 427
Stillwater, NY 12170-0427
Phone (518) 664-4525
Other names
- Schuyler Creek Chiropractic Center
Other providers in Stillwater, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 28, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.