Divine Chiropractic LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

X011437-1 Issued in NY

Legal business name

DIVINE CHIROPRACTIC LLC

Practice address

465 Route 25a
Suite 1
Miller Place, NY 11764

Phone

(631) 384-2023

NPI assigned

Mar 13, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Kathleen Carey Clarkin-Dedio, D.C.

Title

Owner

Phone

(631) 384-2023

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Thomas J Ianniello, D.C.

  • Chiropractor
  • Miller Place, NY
  • NPI 1356491468
  NPD (past)

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

{
    "created_epoch": "1331596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1331596800000",
    "number": "1235404039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "465 ROUTE 25A",
            "address_2": "SUITE 1",
            "city": "MILLER PLACE",
            "state": "NY",
            "postal_code": "11764",
            "telephone_number": "631-384-2023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "465 ROUTE 25A",
            "address_2": "SUITE 1",
            "city": "MILLER PLACE",
            "state": "NY",
            "postal_code": "11764",
            "telephone_number": "631-384-2023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVINE CHIROPRACTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-13",
        "last_updated": "2012-03-13",
        "status": "A",
        "authorized_official_last_name": "CLARKIN-DEDIO",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_middle_name": "CAREY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "631-384-2023",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X011437-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lizabeth Derkevics
• Barbara W. Deturk, PT
• Stacey Devaux, PSY.D.
• Kristin Diamond
• Alaina Dimaria
• Catherine P Dodge, RN
• Donna Lanza Physical Therapy PC
• Denise Bronzino Donowitz, PH.D.
• Courtney Lynn Dorian
• Dr. Robert E. Stoessel, Psychologist, P.C,

• Chiropractor in Miller Place, NY
• Providers in Miller Place, NY by specialty
• Chiropractor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2012; 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.