Kim Stuart Van Der Veer, DC, CCSP

Primary specialty

Sports Physician ChiropractorTaxonomy code 111NS0005X

License

X005017 Issued in NY

Practice address

1134 Troy Schenectady Rd
Latham, NY 12110-1006

Phone

(518) 783-1908

Fax

(518) 783-1909

NPI assigned

Mar 27, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 7

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Specialty

Chiropractic

Education

National College of Chiropractic, 1986

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1143417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1437119062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1134 TROY SCHENECTADY RD",
            "city": "LATHAM",
            "state": "NY",
            "postal_code": "121101006",
            "telephone_number": "518-783-1908",
            "fax_number": "518-783-1909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1134 TROY SCHENECTADY RD",
            "city": "LATHAM",
            "state": "NY",
            "postal_code": "121101006",
            "telephone_number": "518-783-1908",
            "fax_number": "518-783-1909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN DER VEER",
        "first_name": "KIM",
        "middle_name": "STUART",
        "credential": "DC, CCSP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "NY",
            "license": "X005017",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRISM PROV. #",
            "identifier": "141690724-01",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CDPHP PROV. #",
            "identifier": "10019433",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD PROV. #",
            "identifier": "000445021001",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "566114",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "0013200",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ACN GROUP",
            "identifier": "911601",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROV. #",
            "identifier": "X3317",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Maya Valentin, FNP
• Elizabeth Mary Valk, FNP-C
• David J Vallecorsa, DDS
• Gregory Michael Vallecorsa, D.D.S.
• Jonathan David Vallecorsa
• Hoyte T Van Der Zee, M.D.
• Lucy Van Ness, RN
• Nancy Vanallen
• Paige Vanallen
• Robert John Vanzetta, LCSW

• Sports Physician Chiropractor in Latham, NY
• Providers in Latham, NY by specialty
• Sports Physician Chiropractor in New York

• 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.