NPIMap

Organization Active NPI

Summit Chiropractic Center LLC

  • Chiropractor
  • Essex Junction, VT
National Provider Identifier
1154713170
Registry record updated Mar 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
006.0109638 Issued in VT
Legal business name
SUMMIT CHIROPRACTIC CENTER LLC
Practice address
69 Center Rd
Essex Junction, VT 05452-2622
Phone
(802) 662-1047
NPI assigned
Feb 27, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2015

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

Authorized official

Name
Dr. Tilyr Alfred Dunklow, D.C., B.S.NPI 1538551494
Title
Managing Member
Phone
(802) 662-1047

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 111N00000X 006.0109638 VT Primary
ChiropractorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 111N00000X 006.0109165 VT

Addresses

Primary practice location

69 Center Rd
Essex Junction, VT 05452-2622

Mailing address

69 Center Rd
Essex Junction, VT 05452-2622
Phone (802) 662-1047

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150414001814 VT Part B Supplier - Clinic/Group Practice 0345568788 Receives reassigned benefits from 2 practitioners
Practice locations: Essex Junction, VT

National Provider Directory

National Provider Directory

Locations

69 Center Rd
Essex Junction, VT 05452
Phone (802) 662-1047

Practitioners 2

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": "1424995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1425945600000",
    "number": "1154713170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "69 CENTER RD",
            "city": "ESSEX JUNCTION",
            "state": "VT",
            "postal_code": "054522622",
            "telephone_number": "802-662-1047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "69 CENTER RD",
            "city": "ESSEX JUNCTION",
            "state": "VT",
            "postal_code": "054522622",
            "telephone_number": "802-662-1047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMIT CHIROPRACTIC CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-27",
        "last_updated": "2015-03-10",
        "status": "A",
        "authorized_official_last_name": "DUNKLOW",
        "authorized_official_first_name": "TILYR",
        "authorized_official_middle_name": "ALFRED",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "802-662-1047",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C., B.S."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "VT",
            "license": "006.0109638",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "VT",
            "license": "006.0109165",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Essex Junction, VT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 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.