Individual provider Active NPI

Jack Lafosse, D.C.

  • Chiropractor
  • Bay Shore, NY
National Provider Identifier
1780055996
Registry record updated Oct 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
X009251 Issued in NY
Practice address
1374 Richland Blvd
Bay Shore, NY 11706-4947
Phone
(631) 804-9995
NPI assigned
Oct 14, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 14, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X X009251 NY Primary

Addresses

Primary practice location

1374 Richland Blvd
Bay Shore, NY 11706-4947

Mailing address

1374 Richland Blvd
Bay Shore, NY 11706-4947
Phone (631) 804-9995

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
X009251NYMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1444780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444780800000",
    "number": "1780055996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1374 RICHLAND BLVD",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117064947",
            "telephone_number": "631-804-9995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1374 RICHLAND BLVD",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117064947",
            "telephone_number": "631-804-9995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAFOSSE",
        "first_name": "JACK",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-10-14",
        "last_updated": "2015-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X009251",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bay Shore, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2015; 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.