Active NPI
Fleetwood Chiropractic PC
- Chiropractor
- Mount Vernon, NY
National Provider Identifier
1821282930
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- X002707C-1
- Legal business name
- FLEETWOOD CHIROPRACTIC PC
- Practice address
- 25 E Broad St
Mount Vernon, NY 10552-2207 - Phone
- (914) 699-6770
- Fax
- (914) 664-0090
- NPI assigned
- Aug 31, 2007
- Last updated
- Aug 31, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Robert Alan Russell Jr., D.C.
- Title
- President
- Phone
- (914) 699-6770
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | X002707C-1 | NY | Primary |
| Chiropractor | 111N00000X | X004166-1 | NY |
Addresses
Primary practice location
25 E Broad St
Mount Vernon, NY 10552-2207
Mailing address
25 E Broad St
Mount Vernon, NY 10552-2207
Phone (914) 699-6770
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Chiropractor
- Mount Vernon, NY
- NPI 1104850684
-
- Chiropractor
- Yonkers, NY
- NPI 1518009760
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1188518400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1188518400000",
"number": "1821282930",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "25 E BROAD ST",
"city": "MOUNT VERNON",
"state": "NY",
"postal_code": "105522207",
"telephone_number": "914-699-6770",
"fax_number": "914-664-0090"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "25 E BROAD ST",
"city": "MOUNT VERNON",
"state": "NY",
"postal_code": "105522207",
"telephone_number": "914-699-6770",
"fax_number": "914-664-0090"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "FLEETWOOD CHIROPRACTIC PC",
"organizational_subpart": "NO",
"enumeration_date": "2007-08-31",
"last_updated": "2007-08-31",
"status": "A",
"authorized_official_last_name": "RUSSELL",
"authorized_official_first_name": "ROBERT",
"authorized_official_middle_name": "ALAN",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "914-699-6770",
"authorized_official_name_prefix": "Dr.",
"authorized_official_name_suffix": "Jr.",
"authorized_official_credential": "D.C."
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "NY",
"license": "X002707C-1",
"primary": true
},
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "NY",
"license": "X004166-1",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Mount Vernon, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.