Organization Active NPI

Liberty Chiropractic LLC

  • Chiropractor
  • Sykesville, MD
National Provider Identifier
1447621024
Registry record updated Nov 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
LIBERTY CHIROPRACTIC LLC
Practice address
770 Old Liberty Rd Ste 2
Sykesville, MD 21784-8500
Phone
(410) 903-5798
NPI assigned
Oct 8, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2024

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

Authorized official

Name
Desiree Williams, D.C.NPI 1134458292
Title
Chiropractic Physician/Owner
Phone
(410) 903-5798

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 MD Primary

Addresses

Primary practice location

770 Old Liberty Rd Ste 2
Sykesville, MD 21784-8500

Mailing address

1602 Brimfield Cir
Sykesville, MD 21784-5965
Phone (410) 903-5798

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160119002465 MD Part B Supplier - Clinic/Group Practice 0143523589 Receives reassigned benefits from 1 practitioner
Practice locations: Sykesville, MD

National Provider Directory

National Provider Directory

Locations

770 Old Liberty Rd
Ste 2
Sykesville, MD 21784
Phone (410) 795-1244

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": "1444262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730678400000",
    "number": "1447621024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1602 BRIMFIELD CIR",
            "city": "SYKESVILLE",
            "state": "MD",
            "postal_code": "217845965",
            "telephone_number": "410-903-5798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "770 OLD LIBERTY RD STE 2",
            "city": "SYKESVILLE",
            "state": "MD",
            "postal_code": "217848500",
            "telephone_number": "410-903-5798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIBERTY CHIROPRACTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-08",
        "last_updated": "2024-11-04",
        "certification_date": "2024-11-04",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "DESIREE",
        "authorized_official_title_or_position": "CHIROPRACTIC PHYSICIAN/OWNER",
        "authorized_official_telephone_number": "410-903-5798",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MD",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sykesville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2024; 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.