Kevin Waxter, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

DC 006735-L Issued in PA

Practice address

2 Analomink Rd
East Stroudsburg, PA 18301-9001

Phone

(570) 424-9752

Fax

(570) 424-9758

NPI assigned

Oct 15, 2007

Last updated

Oct 15, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1192406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192406400000",
    "number": "1366631475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 WHIPPOORWILL DR",
            "city": "SAYLORSBURG",
            "state": "PA",
            "postal_code": "183539787",
            "telephone_number": "570-424-9752",
            "fax_number": "570-424-9758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 ANALOMINK RD",
            "city": "EAST STROUDSBURG",
            "state": "PA",
            "postal_code": "183019001",
            "telephone_number": "570-424-9752",
            "fax_number": "570-424-9758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAXTER",
        "first_name": "KEVIN",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-10-15",
        "last_updated": "2007-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "PA",
            "license": "DC 006735-L",
            "primary": true
        },
        {
            "code": "111NR0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Rehabilitation",
            "state": "PA",
            "license": "AJ 006735-L",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in East Stroudsburg, PA
• Providers in East Stroudsburg, PA by specialty
• Chiropractor in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 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.

Verify at the official NPI Registry.