Individual provider Active NPI

Robert H Berry Jr., DC

  • Chiropractor
  • Montour Falls, NY
National Provider Identifier
1386717635
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
X008606-1 Issued in NY
Practice address
226 W. Main St.
Montour Falls, NY 14865-0447
Phone
(607) 535-7080
Fax
(607) 535-7007
NPI assigned
Nov 16, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X X008606-1 NY Primary

Addresses

Primary practice location

226 W. Main St.
Montour Falls, NY 14865-0447

Mailing address

226 W. Main St.
PO Box 447
Montour Falls, NY 14865-0447
Phone (607) 535-7080

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080617000518 NY Practitioner - Chiropractic 5092720870 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
New York Chiropractic College, 1996
Medicare assignment
May accept Medicare assignment
Group practices
Hands on Chiropractic PLLCGroup PAC ID 4688743008, 2 clinicians

Practice addresses (Care Compare)

56 Bridge St
Corning, NY 14830-2239
Phone (607) 936-7871

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
X008606-1NYMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Hands on Chiropractic PLLC Chiropractor CurrentSince Mar 1, 2008 Accepting new patients
Advanced Family Chiropractic Chiropractor Past Accepting new patients

Locations

56 Bridge St
Corning, NY 14830
Phone (607) 936-7871

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1163635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1386717635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "226 W. MAIN ST.",
            "address_2": "PO BOX 447",
            "city": "MONTOUR FALLS",
            "state": "NY",
            "postal_code": "148650447",
            "telephone_number": "607-535-7080",
            "fax_number": "607-535-7007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "226 W. MAIN ST.",
            "city": "MONTOUR FALLS",
            "state": "NY",
            "postal_code": "148650447",
            "telephone_number": "607-535-7080",
            "fax_number": "607-535-7007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERRY",
        "first_name": "ROBERT",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X008606-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montour Falls, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.