Individual provider Active NPI

Kevin M Nightingale, D.C.

  • Chiropractor
  • Williamsville, NY
National Provider Identifier
1356483143
Registry record updated Jan 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
X011221-1 Issued in NY
Practice address
154 Plaza Dr
Williamsville, NY 14221-2345
Phone
(716) 204-0784
Fax
(716) 204-0786
NPI assigned
Feb 12, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 27, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3483 NC
Chiropractor 111N00000X X011221-1 NY Primary

Addresses

Primary practice location

154 Plaza Dr
Williamsville, NY 14221-2345

Mailing address

154 Plaza Dr
Williamsville, NY 14221-2345
Phone (716) 204-0784

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070720000731 NY Practitioner - Chiropractic 2769583715 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
New York Chiropractic College, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

154 Plaza Dr
Williamsville, NY 14221-2345
Phone (716) 204-0784

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3483NCMDPsychologist
X011221-1NYMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Nightingale Chiropractic Wellness P.C. Chiropractor CurrentSince Feb 25, 2010 Accepting new patients

Locations

154 Plaza Dr
Williamsville, NY 14221
Phone (716) 204-0784

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.

NPI Registry JSON

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

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580083200000",
    "number": "1356483143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "154 PLAZA DR",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142212345",
            "telephone_number": "716-204-0784",
            "fax_number": "716-204-0786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "154 PLAZA DR",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142212345",
            "telephone_number": "716-204-0784",
            "fax_number": "716-204-0786"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIGHTINGALE",
        "first_name": "KEVIN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-12",
        "last_updated": "2020-01-27",
        "certification_date": "2020-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "3483",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X011221-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsville, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.