Wellness Sport & Spine Chiropractic PLLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

X009961-1 Issued in NY

Legal business name

WELLNESS SPORT & SPINE CHIROPRACTIC PLLC

Practice address

130 Front St
Vestal, NY 13850-1562

Phone

(607) 786-3601

Fax

(607) 834-7029

NPI assigned

Jan 18, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Kim C Miller, DCNPI 1003840711

Title

Doctor

Phone

(607) 786-3601

Specialties & licenses 1

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Practitioners 1

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

• Kim C Miller, DC, ATC

  • Chiropractor
  • Vestal, NY
  • NPI 1003840711
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1402963200000",
    "number": "1417009283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 FRONT ST",
            "city": "VESTAL",
            "state": "NY",
            "postal_code": "138501562",
            "telephone_number": "607-786-3601",
            "fax_number": "607-834-7029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 FRONT ST",
            "city": "VESTAL",
            "state": "NY",
            "postal_code": "138501562",
            "telephone_number": "607-786-3601",
            "fax_number": "607-834-7029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLNESS SPORT & SPINE CHIROPRACTIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-18",
        "last_updated": "2014-06-17",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "KIM",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "607-786-3601",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X009961-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EXCELLUS BC BS",
            "identifier": "000143666",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI INDIVIDUAL",
            "identifier": "1003840711",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CDPHP",
            "identifier": "100651380167",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMEPOS",
            "identifier": "5734880001",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "648821",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jessica Webb, NP
• Janet Weinberg, DO
• Weis Markets Inc
• Amy Nadine Weisser-Bennett, LCSW
• John C Welch Jr., D.O.
• Susan Wenzinger, ANPC
• Emily A West, FNP-C
• Andrea Marie Westbrook
• Stephanie Robin Westphal, OPTICIAN
• Ryan Whinery

• Chiropractor in Vestal, NY
• Providers in Vestal, NY by specialty
• Chiropractor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2014; 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.