NPIMap

Organization Active NPI

Li Chiropractic and Physical Therapy PLLC

Doing business as Block Sports Chiropractic and Physical Therapy

  • Chiropractor
  • Smithtown, NY
National Provider Identifier
1871147595
Registry record updated Jul 31, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
LI CHIROPRACTIC AND PHYSICAL THERAPY PLLC
Doing business as
Block Sports Chiropractic and Physical Therapy
Practice address
301 Maple Ave
Smithtown, NY 11787-4900
Phone
(631) 543-0004
Fax
(631) 864-5428
NPI assigned
Jul 31, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2019

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

Authorized official

Name
Laurie Byrnes
Title
Billing/Credentialing Manager
Phone
(631) 543-0004

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X Primary
Physical Medicine & Rehabilitation PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208100000X

Addresses

Primary practice location

301 Maple Ave
Smithtown, NY 11787-4900

Mailing address

301 Maple Ave
Smithtown, NY 11787-4900
Phone (631) 543-0004

Other practice location 1

260 Middle Country Rd Ste 7
Selden, NY 11784-2569
Phone (631) 696-4371

Other names 1

  • Block Sports Chiropractic and Physical Therapy Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190828002380 NY Part B Supplier - Clinic/Group Practice 8921336942 Receives reassigned benefits from 5 practitioners
Practice locations: Smithtown, NY

National Provider Directory

National Provider Directory
Tax ID family
Abs Chiropractic PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1564531200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1564531200000",
    "number": "1871147595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 MAPLE AVE",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117874900",
            "telephone_number": "631-543-0004",
            "fax_number": "631-864-5428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 MAPLE AVE",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117874900",
            "telephone_number": "631-543-0004",
            "fax_number": "631-864-5428"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "260 Middle Country Rd Ste 7",
            "address_purpose": "LOCATION",
            "city": "Selden",
            "state": "NY",
            "postal_code": "117842569",
            "country_code": "US",
            "telephone_number": "631-696-4371",
            "fax_number": "631-696-1616",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "LI CHIROPRACTIC AND PHYSICAL THERAPY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-31",
        "last_updated": "2019-07-31",
        "status": "A",
        "authorized_official_last_name": "BYRNES",
        "authorized_official_first_name": "LAURIE",
        "authorized_official_title_or_position": "BILLING/CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "631-543-0004"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Block Sports Chiropractic and Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Smithtown, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2019; 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.