Organization Active NPI

Glenmont Chiropractic Office, PLLC

  • Chiropractor
  • Glenmont, NY
National Provider Identifier
1386862472
Registry record updated Sep 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
X007718 Issued in NY
Legal business name
GLENMONT CHIROPRACTIC OFFICE, PLLC
Practice address
398 Feura Bush Rd
Glenmont, NY 12077-2954
Phone
(518) 449-3071
NPI assigned
Apr 23, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2011

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

Authorized official

Name
Jeffrey Riker, D.C.NPI 1477525137
Title
Owner
Phone
(518) 449-3071

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X X007718 NY Primary

Addresses

Primary practice location

398 Feura Bush Rd
Glenmont, NY 12077-2954

Mailing address

398 Feura Bush Rd
Glenmont, NY 12077-2954
Phone (518) 449-3071

Other identifiers 1

IdentifierTypeStateIssuer
AA1681OtherNYMEDICARE ORGANIZATION

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111118000312 NY Part B Supplier - Clinic/Group Practice 6507030095 Receives reassigned benefits from 1 practitioner
Practice locations: Glenmont, NY; W Coxsackie, NY

National Provider Directory

National Provider Directory

Locations

16 Hope Plz
West Coxsackie, NY 12192
Phone (518) 449-3071

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1177286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317081600000",
    "number": "1386862472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "398 FEURA BUSH RD",
            "city": "GLENMONT",
            "state": "NY",
            "postal_code": "120772954",
            "telephone_number": "518-449-3071",
            "fax_number": "518-449-3073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "398 FEURA BUSH RD",
            "city": "GLENMONT",
            "state": "NY",
            "postal_code": "120772954",
            "telephone_number": "518-449-3071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLENMONT CHIROPRACTIC OFFICE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-23",
        "last_updated": "2011-09-27",
        "status": "A",
        "authorized_official_last_name": "RIKER",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "518-449-3071",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X007718",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ORGANIZATION",
            "identifier": "AA1681",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glenmont, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2011; 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.