NPIMap

Organization Active NPI

Manchester Podiatry Center,PC

  • Durable Medical Equipment & Medical Supplies
  • Manchester, CT
National Provider Identifier
1023294808
Registry record updated Apr 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
MANCHESTER PODIATRY CENTER,PC
Practice address
117 E Center St
Manchester, CT 06040-5246
Phone
(860) 649-3338
NPI assigned
Jan 11, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2011

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

Authorized official

Name
Dr. Kenneth L. Wichman, DPM
Title
Podiatrist
Phone
(860) 649-3338

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Primary

Addresses

Primary practice location

117 E Center St
Manchester, CT 06040-5246

Mailing address

117 E Center St
Manchester, CT 06040-5246
Phone (860) 649-3338

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1200009600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1302825600000",
    "number": "1023294808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 E CENTER ST",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060405246",
            "telephone_number": "860-649-3338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 E CENTER ST",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060405246",
            "telephone_number": "860-649-3338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANCHESTER PODIATRY CENTER,PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-11",
        "last_updated": "2011-04-15",
        "status": "A",
        "authorized_official_last_name": "WICHMAN",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "PODIATRIST",
        "authorized_official_telephone_number": "860-649-3338",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manchester, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.