Individual provider Active NPI

Renee M Mooney, D.C.

  • Chiropractor
  • East Syracuse, NY
National Provider Identifier
1710073085
Registry record updated Dec 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
X008640 Issued in NY
Practice address
6701 Manlius Center Rd
Suite 202
East Syracuse, NY 13057-2999
Phone
(315) 882-2498
Fax
(315) 425-8881
NPI assigned
Oct 5, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X X008640 NY Primary

Addresses

Primary practice location

6701 Manlius Center Rd
Suite 202
East Syracuse, NY 13057-2999

Mailing address

6701 Manlius Center Rd
Suite 202
East Syracuse, NY 13057-2999
Phone (315) 882-2498

Other identifiers 1

IdentifierTypeStateIssuer
RA7428OtherNYP-10

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
X008640NYMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Delvin F. Gomez, D.C. Chiropractor Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: mooneyr@hiemail.healtheconnections.org

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": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734480000000",
    "number": "1710073085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6701 MANLIUS CENTER RD",
            "address_2": "SUITE 202",
            "city": "EAST SYRACUSE",
            "state": "NY",
            "postal_code": "130572999",
            "telephone_number": "315-882-2498",
            "fax_number": "315-425-8881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6701 MANLIUS CENTER RD",
            "address_2": "SUITE 202",
            "city": "EAST SYRACUSE",
            "state": "NY",
            "postal_code": "130572999",
            "telephone_number": "315-882-2498",
            "fax_number": "315-425-8881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOONEY",
        "first_name": "RENEE",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-05",
        "last_updated": "2024-12-18",
        "certification_date": "2024-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X008640",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "P-10",
            "identifier": "RA7428",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in East Syracuse, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2024; 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.