Individual provider Active NPI

Kerstin N Medwin, D.C.

  • Chiropractor
  • Loudonville, NY
National Provider Identifier
1134264120
Registry record updated Mar 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
X010877-1 Issued in NY
Practice address
407 Albany Shaker Rd
Loudonville, NY 12211-1902
Phone
(518) 435-1280
NPI assigned
Feb 20, 2007
Last updated
Mar 22, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 22, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X X010877-1 NY Primary

Addresses

Primary practice location

407 Albany Shaker Rd
Loudonville, NY 12211-1902

Mailing address

407 Albany Shaker Rd
Loudonville, NY 12211-1902
Phone (518) 435-1280

Other identifiers 2

IdentifierTypeStateIssuer
10088278OtherNYCDPHP
C10877-1BOtherNYWORKER'S COMPENSATION

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050616000954 NY Practitioner - Chiropractic 8123061397 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
New York Chiropractic College, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

407 Albany Shaker Rd
Suite 200
Loudonville, NY 12211-1900

407 Albany Shaker Rd
Suite 200
Loudonville, NY 12211-1963
Phone (518) 435-1280

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
X010877-1NYMDChiropractor

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": "1171929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521676800000",
    "number": "1134264120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "407 ALBANY SHAKER RD",
            "city": "LOUDONVILLE",
            "state": "NY",
            "postal_code": "122111902",
            "telephone_number": "518-435-1280",
            "fax_number": "518-435-1284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 ALBANY SHAKER RD",
            "city": "LOUDONVILLE",
            "state": "NY",
            "postal_code": "122111902",
            "telephone_number": "518-435-1280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDWIN",
        "first_name": "KERSTIN",
        "middle_name": "N",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-20",
        "last_updated": "2018-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X010877-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CDPHP",
            "identifier": "10088278",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WORKER'S COMPENSATION",
            "identifier": "C10877-1B",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Loudonville, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2018; 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.