Individual provider Active NPI

Edward E Hutter, D.C.

  • Chiropractor
  • Groton, CT
National Provider Identifier
1073679569
Registry record updated Sep 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
000758 Issued in CT
Practice address
1353 Gold Star Hwy
Ste 106
Groton, CT 06340-2755
Phone
(860) 326-5869
Fax
(860) 326-5728
NPI assigned
Dec 29, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 26, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 000758 CT Primary

Addresses

Primary practice location

1353 Gold Star Hwy
Ste 106
Groton, CT 06340-2755

Mailing address

1353 Gold Star Hwy
Ste 106
Groton, CT 06340-2755
Phone (860) 572-1046

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050617000051 CT Practitioner - Chiropractic 8527002278 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1353 Gold Star Hwy
Suite 106
Groton, CT 06340-2755
Phone (860) 326-5869

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
000758CTMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopedic Physical Therapy of Southern New England LLC Past Accepting new patients

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": "1167350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474848000000",
    "number": "1073679569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1353 GOLD STAR HWY",
            "address_2": "STE 106",
            "city": "GROTON",
            "state": "CT",
            "postal_code": "063402755",
            "telephone_number": "860-572-1046",
            "fax_number": "860-536-1472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1353 GOLD STAR HWY",
            "address_2": "STE 106",
            "city": "GROTON",
            "state": "CT",
            "postal_code": "063402755",
            "telephone_number": "860-326-5869",
            "fax_number": "860-326-5728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUTTER",
        "first_name": "EDWARD",
        "middle_name": "E",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-29",
        "last_updated": "2016-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CT",
            "license": "000758",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Groton, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2016; 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.