Individual provider Active NPI

Kristin D Fusco, D.C.

  • Chiropractor
  • Syracuse, NY
National Provider Identifier
1700266186
Registry record updated Apr 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
012949 Issued in NY
Practice address
4922 W Seneca Tpke
Syracuse, NY 13215-2225
Phone
(315) 857-5557
Fax
(315) 320-9235
NPI assigned
Jun 1, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 23, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038.012792 IL
Chiropractor 111N00000X 012949 NY Primary

Addresses

Primary practice location

4922 W Seneca Tpke
Syracuse, NY 13215-2225

Mailing address

4922 W Seneca Tpke
Syracuse, NY 13215-2225
Phone (315) 857-5557

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
038.012792ILMDChiropractor
012949NYMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1433116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555977600000",
    "number": "1700266186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4922 W SENECA TPKE",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132152225",
            "telephone_number": "315-857-5557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4922 W SENECA TPKE",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132152225",
            "telephone_number": "315-857-5557",
            "fax_number": "315-320-9235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUSCO",
        "first_name": "KRISTIN",
        "middle_name": "D",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-06-01",
        "last_updated": "2019-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038.012792",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "012949",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2019; 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.