Wynantskill Chiropractic PC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

X0066141 Issued in NY

Legal business name

WYNANTSKILL CHIROPRACTIC PC

Practice address

492 Pawling Ave
Troy, NY 12180-5834

Phone

(518) 286-3060

Fax

(518) 286-3044

NPI assigned

Dec 28, 2006

Reactivated

Oct 8, 2010

Organization subpart

No

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

Authorized official

Name

Dr. John J O'Brien, DCNPI 1801984877

Title

Doctor / Owner

Phone

(518) 286-3060

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• John J Obrien, DC

  • Chiropractor
  • Troy, NY
  • NPI 1801984877
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1352678400000",
    "number": "1588720338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "492 PAWLING AVE",
            "city": "TROY",
            "state": "NY",
            "postal_code": "121805834",
            "telephone_number": "518-286-3060",
            "fax_number": "518-286-3044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "492 PAWLING AVE",
            "city": "TROY",
            "state": "NY",
            "postal_code": "121805834",
            "telephone_number": "518-286-3060",
            "fax_number": "518-286-3044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WYNANTSKILL CHIROPRACTIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-28",
        "last_updated": "2012-11-12",
        "deactivation_date": "2008-07-28",
        "reactivation_date": "2010-10-08",
        "status": "A",
        "authorized_official_last_name": "O'BRIEN",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "DOCTOR / OWNER",
        "authorized_official_telephone_number": "518-286-3060",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X0066141",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CDPHP",
            "identifier": "10021222",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "X54101",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MVP",
            "identifier": "607980",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WORKERS' COMPENSATION",
            "identifier": "C066144",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Woodland Village LLC (Fawn Ridge Senior Living)
• Morgan M Woodlief
• Kelsey Elizabeth Woods
• Vidia Wray, MS/CAS
• Kathleen Cannon Wright, PT
• Wynantskill Union Free School District
• Janet L Yager, NP
• Atsushi Yamaguchi
• Mary Christine Yamin, MSN /FNP
• Carolle Eileen Yando, ADVANCED CASAC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2012; 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.