Individual provider Active NPI

John Marini

  • Chiropractor
  • Forest Hills, NY
National Provider Identifier
1811362387
Registry record updated Feb 23, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
012760 Issued in NY
Practice address
6915 Austin St
Forest Hills, NY 11375-4255
Phone
(718) 263-3500
NPI assigned
Dec 9, 2015
Last updated
Feb 23, 2017By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 23, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 012760 NY Primary
Single Specialty Group 193400000X 012760 NY

Addresses

Primary practice location

6915 Austin St
Forest Hills, NY 11375-4255

Mailing address

1157 Fairport Rd
Fairport, NY 14450-1237

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230829001534 NC Practitioner - Chiropractic 5294033197 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
New York Chiropractic College, 2015
Medicare assignment
May accept Medicare assignment
Group practices
Integrative Chiropractic and Natural MedicineGroup PAC ID 6204082126, 4 clinicians

Practice addresses (Care Compare)

6580 Old Monroe Rd
Suite a
Indian Trail, NC 28079-5362
Phone (704) 225-8686

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5620NCMDPhysical Therapy Assistant
012760NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Integrative Chiropractic and Natural Medicine Chiropractor CurrentSince Jul 5, 2023 Accepting new patients
Fairport Chiropractic Chiropractor PastSince Feb 15, 2016 Accepting new patients
Katherine M Whipple, MD, PC Single Specialty PastSince Feb 15, 2016 Accepting new patients

Locations

6580 Old Monroe Rd
Ste A
Indian Trail, NC 28079
Phone (704) 225-8686

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1449619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487808000000",
    "number": "1811362387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1157 FAIRPORT RD",
            "city": "FAIRPORT",
            "state": "NY",
            "postal_code": "144501237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6915 AUSTIN ST",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113754255",
            "telephone_number": "718-263-3500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARINI",
        "first_name": "JOHN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-12-09",
        "last_updated": "2017-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "012760",
            "primary": true
        },
        {
            "code": "193400000X",
            "taxonomy_group": "",
            "desc": "Single Specialty",
            "state": "NY",
            "license": "012760",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest Hills, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2017; 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.