Individual provider Active NPI

David S. Spina, D.C.

  • Chiropractor
  • Middletown, NY
National Provider Identifier
1679619480
Registry record updated Oct 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
X006642 Issued in NY
Practice address
201 Dolson Ave
Ste H100
Middletown, NY 10940-6572
Phone
(845) 292-8810
Fax
(845) 292-8832
NPI assigned
Jan 29, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X X006642 NY Primary

Addresses

Primary practice location

201 Dolson Ave
Ste H100
Middletown, NY 10940-6572

Mailing address

21 Mill St
Liberty, NY 12754-2010
Phone (845) 292-8810

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040512001621 NY Practitioner - Chiropractic 9133119217 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Chiropractic Wellness of Middletown PCGroup PAC ID 1850642307, 2 clinicians

Practice addresses (Care Compare)

201 Dolson Ave
Suite H100
Middletown, NY 10940-6572
Phone (845) 381-5905

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
X006642NYMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Chiropractic Wellness of Middletown, P.C. Chiropractor CurrentSince Aug 6, 2018 Accepting new patients

Locations

201 Dolson Ave
Ste H100
Middletown, NY 10940
Phone (845) 381-5905

Organizations & group practices 1

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": "1170028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540425600000",
    "number": "1679619480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 MILL ST",
            "city": "LIBERTY",
            "state": "NY",
            "postal_code": "127542010",
            "telephone_number": "845-292-8810",
            "fax_number": "845-292-8832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 DOLSON AVE",
            "address_2": "STE H100",
            "city": "MIDDLETOWN",
            "state": "NY",
            "postal_code": "109406572",
            "telephone_number": "845-292-8810",
            "fax_number": "845-292-8832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPINA",
        "first_name": "DAVID",
        "middle_name": "S.",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-29",
        "last_updated": "2018-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X006642",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Middletown, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2018; 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.