NPIMap

Organization Active NPI

South Lake Chiropractic P.C.

  • Chiropractor
  • Babylon, NY
National Provider Identifier
1679640775
Registry record updated Aug 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
XOO8445 Issued in NY
Legal business name
SOUTH LAKE CHIROPRACTIC P.C.
Practice address
50 Park Ave
Babylon, NY 11702-1708
Phone
(631) 422-4234
Fax
(631) 422-4243
NPI assigned
Nov 30, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2011

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

Authorized official

Name
Dr. Scott Leslie, DC. ATC
Title
President
Phone
(631) 422-4234

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X XOO8445 NY Primary

Addresses

Primary practice location

50 Park Ave
Babylon, NY 11702-1708

Mailing address

50 Park Ave
Babylon, NY 11702-1708
Phone (631) 422-4234

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 7

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": "1164844800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1312243200000",
    "number": "1679640775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 PARK AVE",
            "city": "BABYLON",
            "state": "NY",
            "postal_code": "117021708",
            "telephone_number": "631-422-4234",
            "fax_number": "631-422-4243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 PARK AVE",
            "city": "BABYLON",
            "state": "NY",
            "postal_code": "117021708",
            "telephone_number": "631-422-4234",
            "fax_number": "631-422-4243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH LAKE CHIROPRACTIC P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-30",
        "last_updated": "2011-08-02",
        "status": "A",
        "authorized_official_last_name": "LESLIE",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "631-422-4234",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC. ATC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "XOO8445",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Babylon, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2011; 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.