Organization Active NPI

Syracuse Family Chiropractic LLC

  • Chiropractor
  • Fayetteville, NY
National Provider Identifier
1194647107
Registry record updated Jul 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
SYRACUSE FAMILY CHIROPRACTIC LLC
Practice address
4000 Medical Center Drive
Suite 301
Fayetteville, NY 13066
Phone
(315) 761-6311
Fax
(315) 204-0824
NPI assigned
Jul 29, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2026

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

Authorized official

Name
Dr. Peter George Nickless, DC
Title
Owner
Phone
(315) 761-6311

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

4000 Medical Center Drive
Suite 301
Fayetteville, NY 13066

Mailing address

4000 Medical Center Drive
Suite 301
Fayetteville, NY 13066
Phone (315) 761-6311

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1785283200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1785283200000",
    "number": "1194647107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 MEDICAL CENTER DRIVE",
            "address_2": "SUITE 301",
            "city": "FAYETTEVILLE",
            "state": "NY",
            "postal_code": "13066",
            "telephone_number": "315-761-6311",
            "fax_number": "315-204-0824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 MEDICAL CENTER DRIVE",
            "address_2": "SUITE 301",
            "city": "FAYETTEVILLE",
            "state": "NY",
            "postal_code": "13066",
            "telephone_number": "315-761-6311",
            "fax_number": "315-204-0824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SYRACUSE FAMILY CHIROPRACTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-07-29",
        "last_updated": "2026-07-29",
        "certification_date": "2026-07-14",
        "status": "A",
        "authorized_official_last_name": "NICKLESS",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "GEORGE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "315-761-6311",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2026; 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.