NPIMap

Organization Active NPI

East Greenbush Chiropractic PLLC

  • Chiropractor
  • East Greenbush, NY
National Provider Identifier
1245706613
Registry record updated Oct 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
EAST GREENBUSH CHIROPRACTIC PLLC
Practice address
569 Columbia Turnpike
East Greenbush, NY 12061
Phone
(518) 477-5000
Fax
(518) 477-5009
NPI assigned
Oct 23, 2018
Last updated
Oct 23, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2018

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

Authorized official

Name
Timothy M Kelly, DCNPI 1730218736
Title
Owner/Provider
Phone
(518) 477-5000

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X Primary

Addresses

Primary practice location

569 Columbia Turnpike
East Greenbush, NY 12061

Mailing address

569 Columbia Turnpike
East Greenbush, NY 12061
Phone (518) 477-5000

National Provider Directory

National Provider Directory
Tax ID family
East Greenbush Chiropractic2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

569 Columbia Tpke
East Greenbush, NY 12061
Phone (518) 477-5000

Practitioners & affiliated clinicians

Practitioners 16

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.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1540252800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1540252800000",
    "number": "1245706613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "569 COLUMBIA TURNPIKE",
            "city": "EAST GREENBUSH",
            "state": "NY",
            "postal_code": "12061",
            "telephone_number": "518-477-5000",
            "fax_number": "518-477-5009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "569 COLUMBIA TURNPIKE",
            "city": "EAST GREENBUSH",
            "state": "NY",
            "postal_code": "12061",
            "telephone_number": "518-477-5000",
            "fax_number": "518-477-5009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST GREENBUSH CHIROPRACTIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-23",
        "last_updated": "2018-10-23",
        "status": "A",
        "authorized_official_last_name": "KELLY",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "518-477-5000",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Greenbush, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2018; 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.