Individual provider Active NPI

Etienne Dubarry, DC

  • Chiropractor
  • Palm Beach Gardens, FL
National Provider Identifier
1164532347
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH0006070 Issued in FL
Practice address
11211 Prosperity Farms Rd
B204
Palm Beach Gardens, FL 33410
Phone
(561) 622-9197
Fax
(561) 622-4964
NPI assigned
Aug 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH0006070 FL Primary

Addresses

Primary practice location

11211 Prosperity Farms Rd
B204
Palm Beach Gardens, FL 33410

Mailing address

11211 Prosperity Farms Rd
B204
Palm Beach Gardens, FL 33410
Phone (561) 622-9197

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
CH0006070FLMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1164532347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11211 PROSPERITY FARMS RD",
            "address_2": "B204",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "33410",
            "telephone_number": "561-622-9197",
            "fax_number": "561-622-4964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11211 PROSPERITY FARMS RD",
            "address_2": "B204",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "33410",
            "telephone_number": "561-622-9197",
            "fax_number": "561-622-4964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUBARRY",
        "first_name": "ETIENNE",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH0006070",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Beach Gardens, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.