John Scott Hitchiner, DC
Individual provider Active NPI Chiropractor · Granby, CT
NPI 1184727992 · NPPES record last updated Oct 1, 2012
Key facts
- NPI
- 1184727992
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 001024 (CT)
- Practice address
- 50 Hartford Ave
Granby, CT 06035 - Phone
- (860) 653-5581
- Fax
- (860) 653-6035
- NPI assigned
- Sep 7, 2006
- Sex
- Male
- Sole proprietor
- Yes
Medicare Care Compare profile
- Specialty
- Chiropractic
- Education
- New York Chiropractic College, 1992
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
50 Hartford Ave
Granby, CT 06035-2306
Phone (860) 653-5581
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CT
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20080604000107 | CT | Practitioner - Chiropractic | 4183794050 | Practice locations: Granby, CT |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 001024 | CT | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 001024 | CT | Yes |
Addresses
Primary practice location
50 Hartford Ave
Granby, CT 06035
Mailing address
PO Box 270
Granby, CT 06035
Phone (860) 653-5581
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 004130887 | Medicaid | CT | |
| 050001024CT02 | Other | CT | ANTHEM BLUE CROSS BLUE SH |
Other providers in Granby, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 1, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.