Active NPI
Keith Brian Duverney
- Chiropractor
- New York, NY
National Provider Identifier
1447350970
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- X011776-1
- Practice address
- 126 Washington PL
New York, NY 10014-6819 - Phone
- (212) 675-6662
- Fax
- (212) 675-6673
- NPI assigned
- Sep 24, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 006621 | GA | |
| Chiropractor | 111N00000X | 7130 | TX | |
| Chiropractor | 111N00000X | X011776-1 | NY | Primary |
Addresses
Primary practice location
126 Washington PL
New York, NY 10014-6819
Mailing address
126 Washington PL
New York, NY 10014-6819
Phone (212) 675-6662
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SC
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20251114003566 | SC | Practitioner - Chiropractic | 9638132350 |
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Other, 1996
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
2155 Alabama Ave
Oneonta, AL 35121-1904
9716 Redstone Dr
Indian Land, SC 29707-5406
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 006621 | GA | MD | Chiropractor |
| X011776-1 | NY | MD | Chiropractor |
| 7130 | TX | MD | Optometrist |
| 4879 | SC | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Relife Pro Corporation | Chiropractor | Current | Accepting new patients |
| Kennesaw Health and Wellness | Chiropractor | Past | Accepting new patients |
| Mudbone Productions Inc | Chiropractor | Past | Accepting new patients |
| Vanessa L. Troise, D.C., P.C. | Chiropractor | Past | Accepting new patients |
| Bankhead Chiropractic | Chiropractor | Past | Accepting new patients |
Locations
9716 Redstone Dr
Indian Land, SC 29707
Phone (803) 992-9966
Organizations & group practices 5
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Chiropractor
- Villa Rica, GA
- NPI 1699953414
-
- Chiropractor
- Indian Land, SC
- NPI 1083421564
-
- Chiropractor
- Massapequa, NY
- NPI 1902961972
-
- Chiropractor
- Kennesaw, GA
- NPI 1427276617
-
- Chiropractor
- Kennesaw, GA
- NPI 1518014877
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159056000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1276819200000",
"number": "1447350970",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "126 WASHINGTON PL",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100146819",
"telephone_number": "212-675-6662",
"fax_number": "212-675-6673"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "126 WASHINGTON PL",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100146819",
"telephone_number": "212-675-6662",
"fax_number": "212-675-6673"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUVERNEY",
"first_name": "KEITH",
"middle_name": "BRIAN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-09-24",
"last_updated": "2010-06-18",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "GA",
"license": "006621",
"primary": false
},
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "TX",
"license": "7130",
"primary": false
},
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "NY",
"license": "X011776-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2010; 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.