Individual provider Active NPI

Tianne A Pape, D.C., M.S.

  • Nutrition Chiropractor
  • East Lyme, CT
National Provider Identifier
1073826533
Registry record updated Apr 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nutrition ChiropractorTaxonomy code 111NN1001X
License
1857 Issued in CT
Practice address
305 Flanders Rd
Suite #6
East Lyme, CT 06333-1743
Phone
(860) 739-3600
Fax
(860) 739-3600
NPI assigned
Jul 26, 2010
Last updated
Apr 17, 2017By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 17, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nutrition Chiropractor 111NN1001X 1857 CT Primary

Addresses

Primary practice location

305 Flanders Rd
Suite #6
East Lyme, CT 06333-1743

Mailing address

PO Box 944
East Lyme, CT 06333-0944
Phone (860) 739-3400

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101105000765 CT Practitioner - Chiropractic 4385839174 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pape Chiropractic and Wellness Center LLCGroup PAC ID 9931394723, 2 clinicians

Practice addresses (Care Compare)

305 Flanders Rd
Unit 8
East Lyme, CT 06333-1743
Phone (860) 739-3600

PO Box
Suite 944
East Lyme, CT 06333-0944

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
1857CTMDBehavioral Analyst

Practice roles

OrganizationSpecialtyStatusNew patients
Pape Chiropractic & Wellness Center LLC Nutrition CurrentSince Sep 3, 2010 Accepting new patients
Advanced Eyecare, LLC PastSince Jan 1, 2007 Accepting new patients

Locations

305 Flanders Rd
Unit 8
East Lyme, CT 06333
Phone (860) 739-3600

11 Freedom Way
Unit B1
Niantic, CT 06357
Phone (860) 739-3600

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1280102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492387200000",
    "number": "1073826533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 944",
            "city": "EAST LYME",
            "state": "CT",
            "postal_code": "063330944",
            "telephone_number": "860-739-3400",
            "fax_number": "860-739-3600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 FLANDERS RD",
            "address_2": "SUITE #6",
            "city": "EAST LYME",
            "state": "CT",
            "postal_code": "063331743",
            "telephone_number": "860-739-3600",
            "fax_number": "860-739-3600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAPE",
        "first_name": "TIANNE",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "D.C., M.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-07-26",
        "last_updated": "2017-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NN1001X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Nutrition",
            "state": "CT",
            "license": "1857",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Apr 17, 2017; 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.