Organization Active NPI

Lakeville Chiropractic, PC

  • Chiropractor
  • New Hyde Park, NY
National Provider Identifier
1265610612
Registry record updated Feb 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
LAKEVILLE CHIROPRACTIC, PC
Practice address
516 Lakeville Rd
New Hyde Park, NY 11040-3006
Phone
(516) 775-0778
Fax
(516) 775-0548
NPI assigned
Feb 7, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2008

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

Authorized official

Name
Dr. Valerie Dawn Tully, DCNPI 1851465348
Title
Chiropractor
Phone
(516) 775-0778

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
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

516 Lakeville Rd
New Hyde Park, NY 11040-3006

Mailing address

516 Lakeville Rd
New Hyde Park, NY 11040-3006
Phone (516) 775-0778

Other names 1

  • CHIROCARE CHIROPRACTIC ASSOC Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080418000081 NY Part B Supplier - Clinic/Group Practice 4587555354 Receives reassigned benefits from 2 practitioners
Practice locations: New Hyde Park, NY

National Provider Directory

National Provider Directory

Locations

516 Lakeville Rd
Ste B
New Hyde Park, NY 11040

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1202342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202342400000",
    "number": "1265610612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "516 LAKEVILLE RD",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110403006",
            "telephone_number": "516-775-0778",
            "fax_number": "516-775-0548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "516 LAKEVILLE RD",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110403006",
            "telephone_number": "516-775-0778",
            "fax_number": "516-775-0548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKEVILLE CHIROPRACTIC, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-07",
        "last_updated": "2008-02-07",
        "status": "A",
        "authorized_official_last_name": "TULLY",
        "authorized_official_first_name": "VALERIE",
        "authorized_official_middle_name": "DAWN",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "516-775-0778",
        "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": [
        {
            "organization_name": "CHIROCARE CHIROPRACTIC ASSOC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in New Hyde Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2008; 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.