Danielle Custode, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

5900 Issued in CO

Practice address

3400 Table Mesa Dr
Suite 201
Boulder, CO 80305-5869

Phone

(303) 499-9442

Fax

(303) 494-8678

NPI assigned

Oct 17, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1192579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204243200000",
    "number": "1295924983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 TABLE MESA DR",
            "address_2": "SUITE 201",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803055869",
            "telephone_number": "303-499-9442",
            "fax_number": "303-494-8678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 TABLE MESA DR",
            "address_2": "SUITE 201",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803055869",
            "telephone_number": "303-499-9442",
            "fax_number": "303-494-8678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUSTODE",
        "first_name": "DANIELLE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-10-17",
        "last_updated": "2008-02-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CO",
            "license": "5900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Boulder, CO
• Providers in Boulder, CO by specialty
• Chiropractor in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 2008; 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.