Organization Active NPI

Clifton Park Chiropractic PLLC

  • Medical Specialty Clinic/Center
  • Halfmoon, NY
National Provider Identifier
1619641727
Registry record updated Aug 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
Legal business name
CLIFTON PARK CHIROPRACTIC PLLC
Practice address
1789 Route 9
Halfmoon, NY 12065-2458
Phone
(518) 930-0049
NPI assigned
Aug 3, 2021
Last updated
Aug 3, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2021

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

Authorized official

Name
Dr. Carolyn Driscoll, DCNPI 1770010803
Title
Owner
Phone
(484) 336-6635

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Specialty Clinic/Center 261QM2500X NU Primary

Addresses

Primary practice location

1789 Route 9
Halfmoon, NY 12065-2458

Mailing address

22 Sweetbriar Dr
Gansevoort, NY 12831-2526
Phone (484) 336-6635

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20211015000534 NY Part B Supplier - Clinic/Group Practice 6103224571 Receives reassigned benefits from 4 practitioners
Practice locations: Halfmoon, NY

National Provider Directory

National Provider Directory

Locations

1789 Route 9
Halfmoon, NY 12065
Phone (518) 371-0246

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1627948800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1627948800000",
    "number": "1619641727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 SWEETBRIAR DR",
            "city": "GANSEVOORT",
            "state": "NY",
            "postal_code": "128312526",
            "telephone_number": "484-336-6635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1789 ROUTE 9",
            "city": "HALFMOON",
            "state": "NY",
            "postal_code": "120652458",
            "telephone_number": "518-930-0049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLIFTON PARK CHIROPRACTIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-03",
        "last_updated": "2021-08-03",
        "certification_date": "2021-08-03",
        "status": "A",
        "authorized_official_last_name": "DRISCOLL",
        "authorized_official_first_name": "CAROLYN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "484-336-6635",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Halfmoon, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2021; 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.