Organization Active NPI

Balanced Living Chiropractic, LLC

  • Chiropractor
  • Amherst, NY
National Provider Identifier
1396724480
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
X010360-1 X010361-1 Issued in NY
Legal business name
BALANCED LIVING CHIROPRACTIC, LLC
Practice address
2140 Eggert Rd
Suite B
Amherst, NY 14226-2055
Phone
(716) 832-1818
Fax
(716) 832-7815
NPI assigned
Jan 17, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Kevin P Phalen, D.C.NPI 1043299167
Title
General Partner
Phone
(716) 832-1818

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
Chiropractor 111N00000X X010360-1 X010361-1 NY Primary

Addresses

Primary practice location

2140 Eggert Rd
Suite B
Amherst, NY 14226-2055

Mailing address

2140 Eggert Rd
Suite B
Amherst, NY 14226-2055
Phone (716) 832-1818

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120128000001 NY Part B Supplier - Clinic/Group Practice 0345415204 Receives reassigned benefits from 4 practitioners
Practice locations: Amherst, NY

National Provider Directory

National Provider Directory

Locations

2140 Eggert Rd
Ste B
Buffalo, NY 14226
Phone (716) 831-0011

Practitioners & affiliated clinicians

Practitioners 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1137456000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1396724480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2140 EGGERT RD",
            "address_2": "SUITE B",
            "city": "AMHERST",
            "state": "NY",
            "postal_code": "142262055",
            "telephone_number": "716-832-1818",
            "fax_number": "716-832-7815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2140 EGGERT RD",
            "address_2": "SUITE B",
            "city": "AMHERST",
            "state": "NY",
            "postal_code": "142262055",
            "telephone_number": "716-832-1818",
            "fax_number": "716-832-7815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BALANCED LIVING CHIROPRACTIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PHALEN",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "GENERAL PARTNER",
        "authorized_official_telephone_number": "716-832-1818",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X010360-1  X010361-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Amherst, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.