Kenneth Russell Marvin, DC

Primary specialty

Sports Physician ChiropractorTaxonomy code 111NS0005X

License

X08559 Issued in NY

Practice address

37 E Central Ave
Pearl River, NY 10965-2306

Phone

(845) 735-4755

Fax

(845) 735-1055

NPI assigned

Aug 24, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Specialty

Chiropractic

Education

New York Chiropractic College, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Marvin Family Chiropractic PC

  • Sports Physician Chiropractor
  • Pearl River, NY
  • NPI 1609054931
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205971200000",
    "number": "1710094933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37 E CENTRAL AVE",
            "city": "PEARL RIVER",
            "state": "NY",
            "postal_code": "109652306",
            "telephone_number": "845-735-4755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37 E CENTRAL AVE",
            "city": "PEARL RIVER",
            "state": "NY",
            "postal_code": "109652306",
            "telephone_number": "845-735-4755",
            "fax_number": "845-735-1055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARVIN",
        "first_name": "KENNETH",
        "middle_name": "RUSSELL",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-24",
        "last_updated": "2008-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "NY",
            "license": "X08559",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kayla Elizabeth Maroney
• Cara Terese Martin, CCC-SLP
• Chabeli Enid Martinez Jimenez
• Nicolina Maria Martini, PHARM.D
• Marvin Family Chiropractic PC
• Preethy Mathew, PHARMACIST
• Eileen MC Aree
• Ramona A MC Carroll, LPN
• Ellen McCabe
• James McCabe

• Sports Physician Chiropractor in Pearl River, NY
• Providers in Pearl River, NY by specialty
• Sports Physician Chiropractor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2008; 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.