Active NPI
Lauren Taylor Van de Water, DC
- Chiropractor
- Cambridge, NY
National Provider Identifier
1508337205
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 013204
- Practice address
- 4 E Main St Ste a
Cambridge, NY 12816-1297 - Phone
- (518) 677-7200
- NPI assigned
- Dec 7, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 013204 | NY | Primary |
Addresses
Primary practice location
4 E Main St Ste a
Cambridge, NY 12816-1297
Mailing address
4 E Main St Ste a
Cambridge, NY 12816-1297
Phone (518) 677-7200
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 013204 | Other | NY | NEW YORK STATE LICENSE |
Other names 1
- Lauren Taylor Carazza
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 013204 | NY | MD | Clinical Child & Adolescent Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1544140800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1708646400000",
"number": "1508337205",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4 E MAIN ST STE A",
"city": "CAMBRIDGE",
"state": "NY",
"postal_code": "128161297",
"telephone_number": "518-677-7200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4 E MAIN ST STE A",
"city": "CAMBRIDGE",
"state": "NY",
"postal_code": "128161297",
"telephone_number": "518-677-7200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VAN DE WATER",
"first_name": "LAUREN",
"middle_name": "TAYLOR",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-12-07",
"last_updated": "2024-02-23",
"certification_date": "2024-02-23",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "NY",
"license": "013204",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NEW YORK STATE LICENSE",
"identifier": "013204",
"state": "NY"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "LAUREN",
"last_name": "CARAZZA",
"middle_name": "TAYLOR",
"credential": "DC",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Cambridge, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.