Modern Spine Health and Injury Care LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

MODERN SPINE HEALTH AND INJURY CARE LLC

Practice address

2 Stony Hill Rd Ste 207
Bethel, CT 06801-1045

Phone

(203) 794-4685

Fax

(203) 870-3321

NPI assigned

Mar 10, 2023

Organization subpart

No

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

Authorized official

Name

Richard Wilson, DCNPI 1316173768

Title

Owner

Phone

(203) 794-4685

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.

• Richard Steven Wilson, DC

  • Chiropractor
  • Bethel, CT
  • NPI 1316173768
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1678406400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678406400000",
    "number": "1205536935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 STONY HILL RD STE 207",
            "city": "BETHEL",
            "state": "CT",
            "postal_code": "068011045",
            "telephone_number": "203-394-2410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 STONY HILL RD STE 207",
            "city": "BETHEL",
            "state": "CT",
            "postal_code": "068011045",
            "telephone_number": "203-794-4685",
            "fax_number": "203-870-3321"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2333 Black Rock Tpke, Lowr Level, Hall 2",
            "address_purpose": "LOCATION",
            "city": "Fairfield",
            "state": "CT",
            "postal_code": "068253220",
            "country_code": "US",
            "telephone_number": "203-794-4685",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MODERN SPINE HEALTH AND INJURY CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-10",
        "last_updated": "2023-03-10",
        "certification_date": "2023-03-10",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "203-794-4685",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Z Fein DPM PC (Bethel Foot and Ankle)
• Victoria Fern Michalek, LCSW
• Milk and More Wellness PLLC
• Randy David Miller, PHARM.D.
• Patricia Mitchell, PSY,D.
• Danielle Monroe, LPC, NBCC
• Susan Montuori
• Binh T Moore, OD
• Luann Moratto, DC
• Barry Morgenstern

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2023; 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.