Back on Track Chiropractic, LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

X009391 Issued in NY

Legal business name

BACK ON TRACK CHIROPRACTIC, LLC

Practice address

8129 Brewerton Rd
Cicero, NY 13039

Phone

(315) 699-9887

NPI assigned

Mar 5, 2008

Last updated

Jan 10, 2012By 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

Dr. Kenneth A Iles, DCNPI 1821015470

Title

Chiropractor/Member

Phone

(315) 699-9887

Specialties & licenses 1

Addresses

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.

• Kenneth A. Iles, DC

  • Chiropractor
  • Cicero, NY
  • NPI 1821015470
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1204675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1326153600000",
    "number": "1366612400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8129 BREWERTON RD",
            "city": "CICERO",
            "state": "NY",
            "postal_code": "13039",
            "telephone_number": "315-699-9887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8129 BREWERTON RD",
            "city": "CICERO",
            "state": "NY",
            "postal_code": "13039",
            "telephone_number": "315-699-9887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BACK ON TRACK CHIROPRACTIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-05",
        "last_updated": "2012-01-10",
        "status": "A",
        "authorized_official_last_name": "ILES",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CHIROPRACTOR/MEMBER",
        "authorized_official_telephone_number": "315-699-9887",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X009391",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole Ashby, LPN
• Associate Hearing Aid Corp
• Jason Michael Astafan
• Elizabeth Azzoto
• Vanessa J. Azzoto, OPTICIAN
• Back to the Future Chiropractic
• Stacey M Banta
• Deborah Jane Bay, RN
• Heather Kay Bienz, FNP-C
• Bismarck NP Psychiatric Services PLLC

• Chiropractor in Cicero, NY
• Providers in Cicero, 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 10, 2012; 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.