Organization Active NPI

JJM Chiropractic, LLC

  • Chiropractor
  • Niskayuna, NY
National Provider Identifier
1467720136
Registry record updated Dec 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
X007787 Issued in NY
Legal business name
JJM CHIROPRACTIC, LLC
Practice address
1756 Union St.
Niskayuna, NY 12309
Phone
(518) 346-2225
Fax
(518) 346-3197
NPI assigned
Dec 8, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2011

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

Authorized official

Name
Gerald Brescia, D.C.NPI 1245254689
Title
Owner
Phone
(518) 346-2225

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 X007787 NY Primary

Addresses

Primary practice location

1756 Union St.
Niskayuna, NY 12309

Mailing address

1756 Union Street
Niskayuna, NY 12309
Phone (518) 346-2225

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111214000013 NY Part B Supplier - Clinic/Group Practice 9133394513 Receives reassigned benefits from 1 practitioner
Practice locations: Niskayuna, NY

National Provider Directory

National Provider Directory

Locations

1756 Union St
Schenectady, NY 12309
Phone (518) 346-2225

Practitioners & affiliated clinicians

Practitioners 1

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": "1323302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1323302400000",
    "number": "1467720136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1756 UNION STREET",
            "city": "NISKAYUNA",
            "state": "NY",
            "postal_code": "12309",
            "telephone_number": "518-346-2225",
            "fax_number": "518-346-3197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1756 UNION ST.",
            "city": "NISKAYUNA",
            "state": "NY",
            "postal_code": "12309",
            "telephone_number": "518-346-2225",
            "fax_number": "518-346-3197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JJM CHIROPRACTIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-08",
        "last_updated": "2011-12-08",
        "status": "A",
        "authorized_official_last_name": "BRESCIA",
        "authorized_official_first_name": "GERALD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "518-346-2225",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X007787",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Niskayuna, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2011; 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.