Robert Dana Detrick, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

X009577-1 Issued in NY

Practice address

601 Gates Rd
Vestal, NY 13850-2288

Phone

(607) 766-9600

Fax

(607) 766-9601

NPI assigned

Aug 22, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Specialty

Chiropractic

Education

New York Chiropractic College, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Detrick Family Chiropractic PLLC

  • Chiropractor
  • Vestal, NY
  • NPI 1750636056
  Medicare reassignment NPD Authorized official
• Leah Humphries

  • Rehabilitation Chiropractor
  • Owego, NY
  • NPI 1932560091
  NPD (past)
• Owego Chiropractic PC

  • Chiropractor
  • Owego, NY
  • NPI 1396899423
  NPD (past)

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

{
    "created_epoch": "1156204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450828800000",
    "number": "1508972647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1461 SUNNYSIDE RD",
            "city": "NICHOLS",
            "state": "NY",
            "postal_code": "138122803",
            "telephone_number": "814-558-0521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 GATES RD",
            "city": "VESTAL",
            "state": "NY",
            "postal_code": "138502288",
            "telephone_number": "607-766-9600",
            "fax_number": "607-766-9601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DETRICK",
        "first_name": "ROBERT",
        "middle_name": "DANA",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-22",
        "last_updated": "2015-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X009577-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Staci Delucia, NP
• Michael James Demetros
• John Jody Dempsey, PH.D.
• Sreenivasa Rao Desai, MD
• Detrick Family Chiropractic PLLC
• Bobbie Jo Deuel-Lewis
• Rachel Lynn Devine, FNP
• Mohan DS Dhillon, MD
• Caitlin S Digiulio, NP
• David Dinhofer, MD

• Chiropractor in Vestal, NY
• Providers in Vestal, NY by specialty
• Chiropractor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.