NPIMap

Organization Active NPI

Lyndonville Family Chiropractic, Inc.

  • Chiropractor
  • Lyndonville, VT
National Provider Identifier
1326254657
Registry record updated Sep 9, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
006-0001143 Issued in VT
Legal business name
LYNDONVILLE FAMILY CHIROPRACTIC, INC.
Practice address
11 Hill St
Lyndonville, VT 05851-8911
Phone
(802) 626-5866
Fax
(802) 626-0980
NPI assigned
May 15, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2009

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

Authorized official

Name
Dr. Karson Ellsworth Clark Jr., D.C.NPI 1942326822
Title
Owner
Phone
(802) 626-5866

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 006-0001143 VT Primary

Addresses

Primary practice location

11 Hill St
Lyndonville, VT 05851-8911

Mailing address

11 Hill St
Lyndonville, VT 05851-8911
Phone (802) 626-5866

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041112000794 VT Part B Supplier - Clinic/Group Practice 8224090881 Receives reassigned benefits from 3 practitioners
Practice locations: Lyndonville, VT

National Provider Directory

National Provider Directory

Locations

11 Hill St
Lyndonville, VT 05851
Phone (802) 626-5866

Practitioners & affiliated clinicians

Practitioners 4

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": "1179187200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1252454400000",
    "number": "1326254657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 HILL ST",
            "city": "LYNDONVILLE",
            "state": "VT",
            "postal_code": "058518911",
            "telephone_number": "802-626-5866",
            "fax_number": "802-626-0980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 HILL ST",
            "city": "LYNDONVILLE",
            "state": "VT",
            "postal_code": "058518911",
            "telephone_number": "802-626-5866",
            "fax_number": "802-626-0980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LYNDONVILLE FAMILY CHIROPRACTIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-15",
        "last_updated": "2009-09-09",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "KARSON",
        "authorized_official_middle_name": "ELLSWORTH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "802-626-5866",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "VT",
            "license": "006-0001143",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lyndonville, VT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2009; 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.