Individual provider Active NPI

Colleen Pace, DC

  • Internist Chiropractor
  • Hamden, CT
National Provider Identifier
1053401901
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internist ChiropractorTaxonomy code 111NI0900X
License
001365 Issued in CT
Practice address
3154 Whitney Ave
Hamden, CT 06518-2321
Phone
(203) 281-9635
Fax
(203) 281-9650
NPI assigned
Oct 13, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internist Chiropractor 111NI0900X 001365 CT Primary

Addresses

Primary practice location

3154 Whitney Ave
Hamden, CT 06518-2321

Mailing address

3154 Whitney Ave
Hamden, CT 06518-2321
Phone (203) 281-9635

Other identifiers 1

IdentifierTypeStateIssuer
004222582MedicaidCA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160415000656 CT Practitioner - Chiropractic 3375841992 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - West Sunnyvale, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pace Chiropractic Wellness Center LLCGroup PAC ID 8123326709, 2 clinicians

Practice addresses (Care Compare)

3154 Whitney Ave
Hamden, CT 06518-2321
Phone (203) 281-9635

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1365CTMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Pace Chiropractic Wellness Center, LLC CurrentSince Jan 3, 2016 Accepting new patients
Lynn Carnaroli Chiropractic Center of Norwich Past Accepting new patients

Locations

3154 Whitney Ave
Hamden, CT 06518
Phone (203) 281-9635

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": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1053401901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3154 WHITNEY AVE",
            "city": "HAMDEN",
            "state": "CT",
            "postal_code": "065182321",
            "telephone_number": "203-281-9635",
            "fax_number": "203-281-9650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3154 WHITNEY AVE",
            "city": "HAMDEN",
            "state": "CT",
            "postal_code": "065182321",
            "telephone_number": "203-281-9635",
            "fax_number": "203-281-9650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PACE",
        "first_name": "COLLEEN",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NI0900X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Internist",
            "state": "CT",
            "license": "001365",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004222582",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hamden, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.