Individual provider Active NPI

Chase William Livingston, DC

  • Chiropractor
  • East Lyme, CT
National Provider Identifier
1003405887
Registry record updated May 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2212 Issued in CT
Practice address
159 Boston Post Rd
East Lyme, CT 06333-1605
Phone
(860) 374-2802
Fax
(860) 271-8115
NPI assigned
Jan 15, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2212 CT Primary

Addresses

Primary practice location

159 Boston Post Rd
East Lyme, CT 06333-1605

Mailing address

159 Boston Post Rd
East Lyme, CT 06333-1605
Phone (860) 374-2802

Other names 1

  • Dr. Chase William Livingston Professional name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210406001063 CT Practitioner - Chiropractic 1850708025 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Mystic Spine & Sport LLC Chiropractor CurrentSince Mar 1, 2021 Accepting new patients
Whitecap Chiropractic LLC Chiropractor CurrentSince Jul 28, 2023 Accepting new patients

Locations

159 Boston Post Rd
East Lyme, CT 06333
Phone (860) 374-2802

12 Coogan Blvd
Ste 202
Mystic, CT 06355
Phone (860) 245-4620

12 Coogan Blvd
Ste 204
Mystic, CT 06355
Phone (860) 245-4620

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1610668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682985600000",
    "number": "1003405887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "159 BOSTON POST RD",
            "city": "EAST LYME",
            "state": "CT",
            "postal_code": "063331605",
            "telephone_number": "860-374-2802",
            "fax_number": "860-271-8115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "159 BOSTON POST RD",
            "city": "EAST LYME",
            "state": "CT",
            "postal_code": "063331605",
            "telephone_number": "860-374-2802",
            "fax_number": "860-271-8115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIVINGSTON",
        "first_name": "CHASE",
        "middle_name": "WILLIAM",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-01-15",
        "last_updated": "2023-05-02",
        "certification_date": "2023-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CT",
            "license": "2212",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHASE",
            "last_name": "LIVINGSTON",
            "middle_name": "WILLIAM",
            "prefix": "DR.",
            "credential": "DC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in East Lyme, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2023; 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.