NPIMap

Organization Active NPI

Sea Change Chiropractic and Wellness

  • Chiropractor
  • Ithaca, NY
National Provider Identifier
1669609350
Registry record updated Dec 3, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
011697 Issued in NY
Legal business name
SEA CHANGE CHIROPRACTIC AND WELLNESS
Practice address
821 Cliff St
Suite 300
Ithaca, NY 14850-2017
Phone
(607) 256-9355
Fax
(607) 275-9355
NPI assigned
Jun 19, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2009

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

Authorized official

Name
Dr. Ammitai Worob, D.C.NPI 1134355613
Title
Chiropractor
Phone
(607) 256-9355

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
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X 011697 NY Primary

Addresses

Primary practice location

821 Cliff St
Suite 300
Ithaca, NY 14850-2017

Mailing address

821 Cliff St
Suite 300
Ithaca, NY 14850-2017
Phone (607) 256-9355

National Provider Directory

National Provider Directory

Locations

821 Cliff St
Ste 300
Ithaca, NY 14850
Phone (607) 256-9355

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1245369600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1259798400000",
    "number": "1669609350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "821 CLIFF ST",
            "address_2": "SUITE 300",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148502017",
            "telephone_number": "607-256-9355",
            "fax_number": "607-275-9355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "821 CLIFF ST",
            "address_2": "SUITE 300",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148502017",
            "telephone_number": "607-256-9355",
            "fax_number": "607-275-9355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEA CHANGE CHIROPRACTIC AND WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-19",
        "last_updated": "2009-12-03",
        "status": "A",
        "authorized_official_last_name": "WOROB",
        "authorized_official_first_name": "AMMITAI",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "607-256-9355",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "011697",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ithaca, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.