Upstate Chiro LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

UPSTATE CHIRO LLC

Doing business as

Upstate Chiro Llc

Practice address

127 Main St
Gardiner, NY 12525-5210

Phone

(845) 255-6080

NPI assigned

Jan 20, 2023

Last updated

Jan 20, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Nichole A Smith, DCNPI 1295895381

Title

Owner

Phone

(845) 255-6080

Specialties & licenses 1

Addresses

Other names 1

• Upstate Chiro Llc Doing business as

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Nichole Ann Smith, D.C.

  • Chiropractor
  • Gardiner, NY
  • NPI 1295895381
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1674172800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674172800000",
    "number": "1346955697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "127 MAIN ST",
            "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",
            "city": "GARDINER",
            "state": "NY",
            "postal_code": "125255210",
            "telephone_number": "845-255-6080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UPSTATE CHIRO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-20",
        "last_updated": "2023-01-20",
        "certification_date": "2023-01-20",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "NICHOLE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "845-255-6080",
        "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": "Upstate Chiro Llc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Nichole Ann Smith, D.C.
• Richard J Smith, LCSW
• Laura Elizabeth Teetz, MS
• Jessica Temple
• Charles Lee Travis II
• Roseanne Carole Vecchione, R-LCSW

• Chiropractor in Gardiner, NY
• Providers in Gardiner, NY by specialty
• Chiropractor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2023; 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.