Active NPI
Mary A. Smith, D.C.
- Chiropractor
- Woodstock, NY
National Provider Identifier
1336349760
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- X005659
- Practice address
- 111 Orchard LN N
Woodstock, NY 12498-1163 - Phone
- (845) 679-6037
- NPI assigned
- Jul 24, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | X005659 | NY | Primary |
Addresses
Primary practice location
111 Orchard LN N
Woodstock, NY 12498-1163
Mailing address
111 Orchard LN N
Woodstock, NY 12498-1163
Phone (845) 679-6037
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| WC CO-56590 | Other | NY | WORKERS COMPENSATION NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| X005659 | NY | MD | Chiropractor |
| 005659 | NY | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1185235200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1185235200000",
"number": "1336349760",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "111 ORCHARD LN N",
"city": "WOODSTOCK",
"state": "NY",
"postal_code": "124981163",
"telephone_number": "845-679-6037"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "111 ORCHARD LN N",
"city": "WOODSTOCK",
"state": "NY",
"postal_code": "124981163",
"telephone_number": "845-679-6037"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "MARY",
"middle_name": "A.",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-07-24",
"last_updated": "2007-07-24",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "NY",
"license": "X005659",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WORKERS COMPENSATION NY",
"identifier": "WC CO-56590",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Woodstock, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.