Island Family Chiropractic Wellness PLLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

ISLAND FAMILY CHIROPRACTIC WELLNESS PLLC

Practice address

400 Kings Mall CT
Kingston, NY 12401-1578

Phone

(846) 663-8299

NPI assigned

Dec 5, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Glenn M. Gibson, D.C.NPI 1619308954

Title

Owner

Phone

(845) 663-8299

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Glenn M. Gibson, D.C.

  • Chiropractor
  • Kingston, NY
  • NPI 1619308954
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1386201600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1669939200000",
    "number": "1861823577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "62 CLOVER ST",
            "city": "WEST HURLEY",
            "state": "NY",
            "postal_code": "124916019",
            "telephone_number": "845-663-8299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 KINGS MALL CT",
            "city": "KINGSTON",
            "state": "NY",
            "postal_code": "124011578",
            "telephone_number": "846-663-8299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ISLAND FAMILY CHIROPRACTIC WELLNESS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-05",
        "last_updated": "2022-12-02",
        "certification_date": "2022-12-02",
        "status": "A",
        "authorized_official_last_name": "GIBSON",
        "authorized_official_first_name": "GLENN",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "845-663-8299",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bogdan Iorgu, MD
• Ruxandra V Iorgu, MD
• Lee Isabell, DO
• Laura Juliane Isele, M.A., R.D., CD-N
• Danielle Isenburg, DO
• Sarin Itty, DO
• Ivyrehab Physical Therapy, Occupational Therapy & Speech Language Pathology, PLLC
• Matiullah Abdul Jabbar, MD
• Rose Ann Jackson
• Madeline Jacobs, CNM

• Chiropractor in Kingston, NY
• Providers in Kingston, NY by specialty
• Chiropractor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2022; 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.