NPIMap

Organization Active NPI

Childress Chiropractic PC

  • Chiropractor
  • De Witt, NY
National Provider Identifier
1184080608
Registry record updated Jan 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
X012698-1 Issued in NY
Legal business name
CHILDRESS CHIROPRACTIC PC
Practice address
4317 E Genesee St
Suite 101
De Witt, NY 13214-2114
Phone
(315) 449-4465
Fax
(315) 449-4466
NPI assigned
Jan 13, 2016
Last updated
Jan 13, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2016

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

Authorized official

Name
Cody Childress, DCNPI 1568848943
Title
Owner
Phone
(315) 449-4465

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X X012698-1 NY Primary

Addresses

Primary practice location

4317 E Genesee St
Suite 101
De Witt, NY 13214-2114

Mailing address

4317 E Genesee St
Suite 101
De Witt, NY 13214-2114
Phone (315) 449-4465

National Provider Directory

National Provider Directory

Locations

4317 E Genesee St
Ste 101
Syracuse, NY 13214
Phone (315) 449-4465

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1452643200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1452643200000",
    "number": "1184080608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4317 E GENESEE ST",
            "address_2": "SUITE 101",
            "city": "DE WITT",
            "state": "NY",
            "postal_code": "132142114",
            "telephone_number": "315-449-4465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4317 E GENESEE ST",
            "address_2": "SUITE 101",
            "city": "DE WITT",
            "state": "NY",
            "postal_code": "132142114",
            "telephone_number": "315-449-4465",
            "fax_number": "315-449-4466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILDRESS CHIROPRACTIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-13",
        "last_updated": "2016-01-13",
        "status": "A",
        "authorized_official_last_name": "CHILDRESS",
        "authorized_official_first_name": "CODY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "315-449-4465",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X012698-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in De Witt, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2016; 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.