Kaycie A Kimberlin, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

X009059-1 Issued in NY

Practice address

327 Broadway
Port Ewen, NY 12466-5501

Phone

(845) 331-8810

NPI assigned

Dec 27, 2006

Sex

Female

Sole proprietor

No

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

Other, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Abundant Life Chiropractic a Creating Wellness Center

  • Chiropractor
  • Port Ewen, NY
  • NPI 1457539074
  NPD (past) Authorized official

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

{
    "created_epoch": "1167177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343952000000",
    "number": "1780749986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 927",
            "city": "PORT EWEN",
            "state": "NY",
            "postal_code": "124660927",
            "telephone_number": "845-331-8810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "327 BROADWAY",
            "city": "PORT EWEN",
            "state": "NY",
            "postal_code": "124665501",
            "telephone_number": "845-331-8810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIMBERLIN",
        "first_name": "KAYCIE",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-27",
        "last_updated": "2012-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X009059-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leah Elizabeth Gherardi, SPECIAL EDUCATION
• Lisamarie Grosso, RN
• Krystina Marie Gualtieri, RN
• Maria Alexandra Hayda, TVI
• Leigh Ellen Hill, RPH
• Walter Dale Kimberlin Jr., D.C.
• Stephen A Kleinman, DDS
• William Latimer, LCSW
• Franc John Libihoul, L.C.S.W.
• Helena Ann Marchetti, PHARM. D.

• All providers in Port Ewen, NY
• Chiropractor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2012; 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.