Individual provider Active NPI

Charmagne M Flanigan, DC

  • Chiropractor
  • Lakeville, NY
National Provider Identifier
1720049679
Registry record updated May 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
63931 Issued in NY
Practice address
6005 Big Tree Road
Lakeville, NY 14480-9720
Phone
(585) 346-9150
Fax
(585) 346-4528
NPI assigned
Mar 30, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 9, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 63931 NY Primary

Addresses

Primary practice location

6005 Big Tree Road
Lakeville, NY 14480-9720

Mailing address

6005 Big Tree Road
Lakeville, NY 14480-9720
Phone (585) 346-9150

Other identifiers 1

IdentifierTypeStateIssuer
12279AOtherNYMEDICARE PTAN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080502000374 NY Practitioner - Chiropractic 1951480813 Practice locations: Lakeville, NY

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
National College of Chiropractic, 1990
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

6005 Big Tree Rd
Lakeville, NY 14480-9720
Phone (585) 346-9150

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
63931NYMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Caitlin Simpson Chiropractic PLLC Chiropractor Past Accepting new patients

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": "1143676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210291200000",
    "number": "1720049679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6005 BIG TREE ROAD",
            "city": "LAKEVILLE",
            "state": "NY",
            "postal_code": "144809720",
            "telephone_number": "585-346-9150",
            "fax_number": "585-346-4528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6005 BIG TREE ROAD",
            "city": "LAKEVILLE",
            "state": "NY",
            "postal_code": "144809720",
            "telephone_number": "585-346-9150",
            "fax_number": "585-346-4528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLANIGAN",
        "first_name": "CHARMAGNE",
        "middle_name": "M",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-03-30",
        "last_updated": "2008-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "63931",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "12279A",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeville, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 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.