Individual provider Active NPI

Andrew Steven Black, D.C.

  • Chiropractor
  • New York, NY
National Provider Identifier
1457480659
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
X005812 Issued in NY
Practice address
64 Fulton St
Ground Floor Office
New York, NY 10038-1854
Phone
(212) 791-5900
Fax
(212) 227-3779
NPI assigned
Mar 5, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X X005812 NY Primary

Addresses

Primary practice location

64 Fulton St
Ground Floor Office
New York, NY 10038-1854

Mailing address

64 Fulton St
Ground Floor Office
New York, NY 10038-1854
Phone (212) 791-5900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
X005812NYMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1457480659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "64 FULTON ST",
            "address_2": "GROUND FLOOR OFFICE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100381854",
            "telephone_number": "212-791-5900",
            "fax_number": "212-227-3779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "64 FULTON ST",
            "address_2": "GROUND FLOOR OFFICE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100381854",
            "telephone_number": "212-791-5900",
            "fax_number": "212-227-3779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACK",
        "first_name": "ANDREW",
        "middle_name": "STEVEN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X005812",
            "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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.