Individual provider Active NPI

Kirsten Hamilton Degonzague, DC

  • Chiropractor
  • Albany, NY
National Provider Identifier
1164510913
Registry record updated Jun 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
X009755-1 Issued in NY
Practice address
344 Fuller Rd
Inner Balance Chiropractic
Albany, NY 12203-3647
Phone
(518) 482-2003
Fax
(518) 482-2087
NPI assigned
Oct 10, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 30, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X X009755-1 NY Primary

Addresses

Primary practice location

344 Fuller Rd
Inner Balance Chiropractic
Albany, NY 12203-3647

Mailing address

44 Swartson CT
Albany, NY 12209-1237
Phone (518) 489-0963

Other identifiers 2

IdentifierTypeStateIssuer
10095460OtherNYCDPHP PROVIDER NUMBER
CO9755-2OtherNYWORKER COMP

Other names 1

  • Kirsten Ann Hamilton Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
X009755-1NYMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Niskayuna Life Chiropractic Chiropractor Past Accepting new patients
Inner Balance Chiropractic Chiropractor PastSince Jan 1, 1990 Accepting new patients
The Ideal U, LLC Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214784000000",
    "number": "1164510913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44 SWARTSON CT",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122091237",
            "telephone_number": "518-489-0963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "344 FULLER RD",
            "address_2": "INNER BALANCE CHIROPRACTIC",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122033647",
            "telephone_number": "518-482-2003",
            "fax_number": "518-482-2087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEGONZAGUE",
        "first_name": "KIRSTEN",
        "middle_name": "HAMILTON",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-10",
        "last_updated": "2008-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X009755-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CDPHP PROVIDER NUMBER",
            "identifier": "10095460",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WORKER COMP",
            "identifier": "CO9755-2",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIRSTEN",
            "last_name": "HAMILTON",
            "middle_name": "ANN",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Albany, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.