Active NPI
Mitchell Mason Gordon, D.C.
- Neurology Chiropractor
- Norwalk, CT
National Provider Identifier
1184845356
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurology Chiropractor
- License
- 000976
- Practice address
- 233 New Canaan Ave
Norwalk, CT 06850-1416 - Phone
- (203) 846-0421
- Fax
- (203) 849-9022
- NPI assigned
- May 2, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurology Chiropractor | 111NN0400X | 000976 | CT | Primary |
Addresses
Primary practice location
233 New Canaan Ave
Norwalk, CT 06850-1416
Mailing address
233 New Canaan Ave
Norwalk, CT 06850-1416
Phone (203) 846-0421
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 050000976CT02 | Other | CT | ANTHEM BLUE CROSS & BLUE |
| 720384 | Other | CT | CTCARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178064000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1184845356",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "233 NEW CANAAN AVE",
"city": "NORWALK",
"state": "CT",
"postal_code": "068501416",
"telephone_number": "203-846-0421",
"fax_number": "203-849-9022"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "233 NEW CANAAN AVE",
"city": "NORWALK",
"state": "CT",
"postal_code": "068501416",
"telephone_number": "203-846-0421",
"fax_number": "203-849-9022"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GORDON",
"first_name": "MITCHELL",
"middle_name": "MASON",
"name_prefix": "Mr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-02",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111NN0400X",
"taxonomy_group": "",
"desc": "Chiropractor, Neurology",
"state": "CT",
"license": "000976",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BLUE CROSS & BLUE",
"identifier": "050000976CT02",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CTCARE",
"identifier": "720384",
"state": "CT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Norwalk, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.