Abundant Life Chiropractic a Creating Wellness Center

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

X009059 Issued in NY

Legal business name

ABUNDANT LIFE CHIROPRACTIC A CREATING WELLNESS CENTER

Practice address

327 Broadway
Port Ewen, NY 12466-0927

Phone

(845) 331-8810

NPI assigned

Feb 6, 2008

Last updated

Feb 6, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Kaycie A Kimberlin, DCNPI 1780749986

Title

Partner

Phone

(845) 331-8810

Specialties & licenses 1

Addresses

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kaycie A Kimberlin, DC

  • Chiropractor
  • Port Ewen, NY
  • NPI 1780749986
  NPD (past) Authorized official
• Walter Dale Kimberlin Jr., D.C.

  • Chiropractor
  • Port Ewen, NY
  • NPI 1316004781
  NPD (past)

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

{
    "created_epoch": "1202256000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202256000000",
    "number": "1457539074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "327 BROADWAY",
            "city": "PORT EWEN",
            "state": "NY",
            "postal_code": "124660927",
            "telephone_number": "845-331-8810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "327 BROADWAY",
            "city": "PORT EWEN",
            "state": "NY",
            "postal_code": "124660927",
            "telephone_number": "845-331-8810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ABUNDANT LIFE CHIROPRACTIC A CREATING WELLNESS CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-06",
        "last_updated": "2008-02-06",
        "status": "A",
        "authorized_official_last_name": "KIMBERLIN",
        "authorized_official_first_name": "KAYCIE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "845-331-8810",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X009059",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John A Anderson, MD
• Arms Acres, Inc.
• Jill Borner, LCSWR
• Pamela J. Buono, MS,RD,CDN,CDE
• Olivia Francesca Cea, MSW

• Chiropractor in Port Ewen, NY
• Providers in Port Ewen, NY by specialty
• Chiropractor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2008; 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.