Malletts Bay Chiropractic

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

808 Issued in VT

Legal business name

MALLETTS BAY CHIROPRACTIC

Practice address

500 Heineberg Dr
Colchester, VT 05446-6772

Phone

(802) 865-2255

NPI assigned

Oct 12, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Kenneth M Liebman, DCNPI 1821188244

Title

Partner

Phone

(802) 865-2255

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kenneth M Liebman, DC

  • Chiropractor
  • Colchester, VT
  • NPI 1821188244
  NPD (past) Authorized official
• Ivy R Liebman, DC

  • Chiropractor
  • Colchester, VT
  • NPI 1396834966
  NPD (past)

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1184713737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 768",
            "city": "COLCHESTER",
            "state": "VT",
            "postal_code": "054460768",
            "telephone_number": "802-865-2255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 HEINEBERG DR",
            "city": "COLCHESTER",
            "state": "VT",
            "postal_code": "054466772",
            "telephone_number": "802-865-2255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MALLETTS BAY CHIROPRACTIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LIEBMAN",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "802-865-2255",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "VT",
            "license": "808",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VT BLUE CROSS",
            "identifier": "4427",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kevin Maguire, MD
• Mahoney Chiropractic Group, LLC
• Kenzie Mahoney, DC
• Carrie Mailloux
• Mallett'S Bay Dentistry
• Sean T Maloney, MD
• Elizabeth Browning Mangat, CMT
• Marathon Health,LLC
• Mark a Healey MD PC
• Joan Marie Marsh-Reed

• Chiropractor in Colchester, VT
• Providers in Colchester, VT by specialty
• Chiropractor in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.