Individual provider Active NPI

Michelle Doyle, D.C.

  • Chiropractor
  • Boonville, NY
National Provider Identifier
1801033865
Registry record updated Dec 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
X010075-1 Issued in NY
Practice address
119 Main St Ste 2
Boonville, NY 13309-1385
Phone
(315) 358-4031
NPI assigned
Jan 13, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X X010075-1 NY Primary

Addresses

Primary practice location

119 Main St Ste 2
Boonville, NY 13309-1385

Mailing address

119 Main St Ste 2
Boonville, NY 13309-1385
Phone (315) 358-4031

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, NY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20111114000670 WA Practitioner - Chiropractic 7618141474 Reassigns benefits to 1 organization
I20190131002403 NY Practitioner - Chiropractic 7618141474 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
X010075-1NYMDChiropractor
010075NYMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Chiropractic and Wellness, PLLC Chiropractor CurrentSince May 1, 2017 Accepting new patients
MG Dodge Chiropractic, PC Chiropractor CurrentSince Jan 1, 2019 Accepting new patients

Locations

7383C Utica Blvd
Lowville, NY 13367

8479 Ridge Rd
Sodus, NY 14551
Phone (315) 498-0243

1420 Roosevelt Ave
Ste 7
Mount Vernon, WA 98273
Phone (360) 424-4186

Organizations & group practices 2

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": "1231804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608076800000",
    "number": "1801033865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 MAIN ST STE 2",
            "city": "BOONVILLE",
            "state": "NY",
            "postal_code": "133091385",
            "telephone_number": "315-358-4031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 MAIN ST STE 2",
            "city": "BOONVILLE",
            "state": "NY",
            "postal_code": "133091385",
            "telephone_number": "315-358-4031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOYLE",
        "first_name": "MICHELLE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-01-13",
        "last_updated": "2020-12-16",
        "certification_date": "2020-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X010075-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boonville, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.