Nichole Ann Smith, D.C.

Key facts

NPI

1295895381

Entity type

Individual (NPI type 1)

Primary specialty

Chiropractor 111N00000X

License

X011333 (NY)

Practice address

127 Main St Ste C
Gardiner, NY 12525-5210

Phone

(845) 255-6080

NPI assigned

Dec 11, 2006

Sex

Female

Sole proprietor

No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Upstate Chiro LLC Chiropractor · Gardiner, NY · NPI 1346955697
  Medicare reassignment NPD Authorized official CHIROPRACTOR · NY

Medicare Care Compare profile

Specialty

Chiropractic

Education

New York Chiropractic College, 2006

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare participation

Medicare fee-for-service enrollment

Enrolled in NY

Medicare enrollment records

National Provider Directory

Medicare enrollment (NPD)

Yes

State licenses

Practice roles

Locations

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jan 20, 2023.

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674172800000",
    "number": "1295895381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "127 MAIN ST STE C",
            "city": "GARDINER",
            "state": "NY",
            "postal_code": "125255210",
            "telephone_number": "845-255-6080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "127 MAIN ST STE C",
            "city": "GARDINER",
            "state": "NY",
            "postal_code": "125255210",
            "telephone_number": "845-255-6080"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2 Malden Ave",
            "address_purpose": "LOCATION",
            "city": "Saugerties",
            "state": "NY",
            "postal_code": "124771700",
            "country_code": "US",
            "telephone_number": "845-246-5020",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "NICHOLE",
        "middle_name": "ANN",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-11",
        "last_updated": "2023-01-20",
        "certification_date": "2023-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X011333",
            "primary": true
        },
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "NY",
            "license": "X011333",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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All providers in Gardiner, NY · Chiropractor in New York