Shoreline Chiropractic Center, LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

1155 Issued in CT

Legal business name

SHORELINE CHIROPRACTIC CENTER, LLC

Practice address

82 Bradley Rd
Madison, CT 06443-2684

Phone

(203) 245-2639

NPI assigned

Jun 13, 2012

Last updated

Jun 13, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. John David Mastrobattisto, D.C.NPI 1902979263

Title

Owner/Member

Phone

(203) 245-2639

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

Enrollment records 1

Locations

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.

• John D Mastrobattisto, D.C.

  • Chiropractor
  • Madison, CT
  • NPI 1902979263
  Medicare reassignment NPD Authorized official
• Jacob Riley Calder

  • Chiropractor
  • Middletown, CT
  • NPI 1194365239
  Medicare reassignment NPD

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

{
    "created_epoch": "1339545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1339545600000",
    "number": "1003178179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "82 BRADLEY RD",
            "city": "MADISON",
            "state": "CT",
            "postal_code": "064432684",
            "telephone_number": "203-245-2639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "82 BRADLEY RD",
            "city": "MADISON",
            "state": "CT",
            "postal_code": "064432684",
            "telephone_number": "203-245-2639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHORELINE CHIROPRACTIC CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-13",
        "last_updated": "2012-06-13",
        "status": "A",
        "authorized_official_last_name": "MASTROBATTISTO",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "OWNER/MEMBER",
        "authorized_official_telephone_number": "203-245-2639",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CT",
            "license": "1155",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Serle M. Epstein M.D.
• Shari a. Roguski DC, LLC
• Ryan Shook, LCSW
• Shore Wellness CT
• Shoreline Anesthesia Associates LLC
• Shoreline Medical Associates LLC
• Shoreline Pediatrics & Adolescent Medicine, P.C.
• Shoreline Psychological
• Shoreline Psychotherapy Crisis and Consultation Center LLC
• Shoreline Speech Therapy

• Chiropractor in Madison, CT
• Providers in Madison, CT by specialty
• Chiropractor in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2012; 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.