Courtney Ann Slack, DC, LAT, ATC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

5732 Issued in NC

Practice address

10012 Old State Rd
Dalton, NY 14836-9640

Phone

(716) 307-9592

NPI assigned

Feb 26, 2024

Last updated

Feb 26, 2024By the provider in NPPES

Sex

Female

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 PA

Enrollment records 1

Specialty

Chiropractic

Education

New York Chiropractic College, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Backcountry Spine and Sport IncGroup PAC ID 9638591514, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Backcountry Spine and Sport Inc

  • Chiropractor
  • Lemont, PA
  • NPI 1881232056
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1708905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708905600000",
    "number": "1932965068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10012 OLD STATE RD",
            "city": "DALTON",
            "state": "NY",
            "postal_code": "148369640",
            "telephone_number": "716-307-9592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10012 OLD STATE RD",
            "city": "DALTON",
            "state": "NY",
            "postal_code": "148369640",
            "telephone_number": "716-307-9592"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SLACK",
        "first_name": "COURTNEY",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "DC, LAT, ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-26",
        "last_updated": "2024-02-26",
        "certification_date": "2024-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "5732",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christina Boss, MS
• Cassandra L. Hugi, RN
• Robin Renee Livingston, LPN
• Plan B Express Transit, LLC
• Michele Remington
• Stephanie Lynn Timothy

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2024; 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.