Individual provider Active NPI

Nelleke Greendyk, D.C

  • Nutrition Chiropractor
  • Warwick, NY
National Provider Identifier
1528135290
Registry record updated Apr 7, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nutrition ChiropractorTaxonomy code 111NN1001X
License
X004528-1 Issued in NY
Practice address
214 Ronald Reagan Blvd
Warwick, NY 10990-4107
Phone
(845) 986-9222
NPI assigned
Nov 29, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 7, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nutrition Chiropractor 111NN1001X X004528-1 NY Primary

Addresses

Primary practice location

214 Ronald Reagan Blvd
Warwick, NY 10990-4107

Mailing address

13 Glennon Rd
West Milford, NJ 07480-2708
Phone (973) 208-9774

Other identifiers 1

IdentifierTypeStateIssuer
1528135290OtherNPI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090401000072 NY Practitioner - Chiropractic 7416014766 Practice locations: Warwick, NY

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
National College of Chiropractic, 1985
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

214 Ronald Reagan Blvd
Warwick, NY 10990-4107
Phone (845) 986-9222

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
X004528-1NYMDNutrition Chiropractor
004528NYMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Frank W Welling III D.C PastSince May 14, 2023 Accepting new patients
Wayne Rossi, D.C.,P.C. PastSince Mar 31, 2008 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1239062400000",
    "number": "1528135290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13 GLENNON RD",
            "city": "WEST MILFORD",
            "state": "NJ",
            "postal_code": "074802708",
            "telephone_number": "973-208-9774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "214 RONALD REAGAN BLVD",
            "city": "WARWICK",
            "state": "NY",
            "postal_code": "109904107",
            "telephone_number": "845-986-9222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENDYK",
        "first_name": "NELLEKE",
        "name_prefix": "Dr.",
        "credential": "D.C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-29",
        "last_updated": "2009-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NN1001X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Nutrition",
            "state": "NY",
            "license": "X004528-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1528135290",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Warwick, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2009; 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.