NPIMap

Organization Active NPI

Bayside Chiropractic, LLC

  • Chiropractor
  • Bayside, NY
National Provider Identifier
1487798591
Registry record updated Jul 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
X002968-1 Issued in NY
Legal business name
BAYSIDE CHIROPRACTIC, LLC
Practice address
21015 Northern Blvd
Bayside, NY 11361-3239
Phone
(718) 279-9485
Fax
(718) 279-0986
NPI assigned
Feb 20, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2008

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

Authorized official

Name
Melinda Keller, DC
Title
Owner
Phone
(718) 279-9485

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X X002968-1 NY Primary

Addresses

Primary practice location

21015 Northern Blvd
Bayside, NY 11361-3239

Mailing address

21015 Northern Blvd
Bayside, NY 11361-3239
Phone (718) 279-9485

Other identifiers 1

IdentifierTypeStateIssuer
BAZ0S306Y10OtherNYBCBS

National Provider Directory

National Provider Directory

Locations

21015 Northern Blvd
Flushing, NY 11361
Phone (718) 279-9485

Practitioners & affiliated clinicians

Practitioners 5

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": "1171929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215561600000",
    "number": "1487798591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21015 NORTHERN BLVD",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "113613239",
            "telephone_number": "718-279-9485",
            "fax_number": "718-279-0986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21015 NORTHERN BLVD",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "113613239",
            "telephone_number": "718-279-9485",
            "fax_number": "718-279-0986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAYSIDE CHIROPRACTIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-20",
        "last_updated": "2008-07-09",
        "status": "A",
        "authorized_official_last_name": "KELLER",
        "authorized_official_first_name": "MELINDA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "718-279-9485",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X002968-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "BAZ0S306Y10",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayside, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.