Northern Lights Family Chiropractic PLLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

NORTHERN LIGHTS FAMILY CHIROPRACTIC PLLC

Practice address

65 S Main St Ste 1
Waterbury, VT 05676-1548

Phone

(802) 882-8777

NPI assigned

Feb 4, 2021

Organization subpart

No

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

Authorized official

Name

Jennifer Domey, DC

Title

Owner, Chirorpactor

Phone

(860) 949-2868

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VT

Enrollment records 1

Locations

Practitioners 1

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

• Jennier Domey, DC

  • Chiropractor
  • Waterbury, VT
  • NPI 1053903781
  Medicare reassignment NPD

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

{
    "created_epoch": "1612396800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614816000000",
    "number": "1265024905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65 S MAIN ST STE 1",
            "city": "WATERBURY",
            "state": "VT",
            "postal_code": "056761548",
            "telephone_number": "802-882-8777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 S MAIN ST STE 1",
            "city": "WATERBURY",
            "state": "VT",
            "postal_code": "056761548",
            "telephone_number": "802-882-8777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHERN LIGHTS FAMILY CHIROPRACTIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-04",
        "last_updated": "2021-03-04",
        "certification_date": "2021-03-04",
        "status": "A",
        "authorized_official_last_name": "DOMEY",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "OWNER, CHIRORPACTOR",
        "authorized_official_telephone_number": "860-949-2868",
        "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": []
}

• Kately Logan Mosher, LCMHC, LPC
• Mount Mansfield Dentistry PLC
• Richard G Munson, MD
• Regina S Murphy, M.A.
• Robert W Murray, MD
• Travis A. Nutting, MSCMH
• Ana O'Neill, M.S.
• Viann Oden, MA, LMFT
• Seong Hwan Park, DDS
• Victoria L. Pawulak, ADN, RN

• All providers in Waterbury, VT
• Chiropractor in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.