Kenneth M Liebman, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

808 Issued in VT

Practice address

500 Heineberg Dr
Colchester, VT 05446-6772

Phone

(802) 865-2255

NPI assigned

Oct 14, 2006

Sex

Male

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 VT

Enrollment records 1

Specialty

Chiropractic

Education

National College of Chiropractic, 1987

Medicare assignment

May accept Medicare assignment

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.

• Malletts Bay Chiropractic

  • Chiropractor
  • Colchester, VT
  • NPI 1184713737
  NPD (past) Authorized official

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

{
    "created_epoch": "1160784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1821188244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 768",
            "city": "COLCHESTER",
            "state": "VT",
            "postal_code": "054460768",
            "telephone_number": "802-865-2255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 HEINEBERG DR",
            "city": "COLCHESTER",
            "state": "VT",
            "postal_code": "054466772",
            "telephone_number": "802-865-2255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIEBMAN",
        "first_name": "KENNETH",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "VT",
            "license": "808",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jason Nicholas Leuck, PHARM. D.
• Larry Levine, OTR
• Christopher J Lewis, PT
• Hailey L Libbey
• Ivy R Liebman, DC
• Liscio Family Dentistry, Inc.
• John Liscio, DMD
• Danielle Long, LCMHC
• Jeffrey Michael Look, P.T.
• Rebecca Ellen Louko, PT

• Chiropractor in Colchester, VT
• Providers in Colchester, VT by specialty
• Chiropractor in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.