Energetic Spine Chiropractic

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

001934 Issued in CT

Legal business name

ENERGETIC SPINE CHIROPRACTIC

Practice address

1271 South Broad St.
Unit #11
Wallingford, CT 06492

Phone

(301) 247-3973

NPI assigned

Oct 9, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Sarah AndersonNPI 1740623610

Title

Doctor of Chiropractic

Phone

(301) 247-3973

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Sarah Anderson, DC

  • Chiropractor
  • Newington, CT
  • NPI 1740623610
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1444348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1444348800000",
    "number": "1083085518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "72 NEW CHESHIRE RD",
            "city": "MERIDEN",
            "state": "CT",
            "postal_code": "064515072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1271 SOUTH BROAD ST.",
            "address_2": "UNIT #11",
            "city": "WALLINGFORD",
            "state": "CT",
            "postal_code": "06492",
            "telephone_number": "301-247-3973"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENERGETIC SPINE CHIROPRACTIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-09",
        "last_updated": "2015-10-09",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "SARAH",
        "authorized_official_title_or_position": "DOCTOR OF CHIROPRACTIC",
        "authorized_official_telephone_number": "301-247-3973",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "CT",
            "license": "001934",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Wallingford, CT
• Providers in Wallingford, CT by specialty
• Chiropractor in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2015; 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.