Individual provider Active NPI

Keith Scott Overland, D.C.

  • Sports Physician Chiropractor
  • Norwalk, CT
National Provider Identifier
1265442834
Registry record updated Jan 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Physician ChiropractorTaxonomy code 111NS0005X
License
333 Issued in CT
Practice address
83 East Ave Ste 313
Norwalk, CT 06851-4902
Phone
(203) 838-9795
Fax
(203) 853-2078
NPI assigned
Aug 8, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 11, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Physician Chiropractor 111NS0005X 333 CT Primary

Addresses

Primary practice location

83 East Ave Ste 313
Norwalk, CT 06851-4902

Mailing address

83 East Ave Ste 313
Norwalk, CT 06851-4902
Phone (203) 838-9795

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090603000486 CT Practitioner - Chiropractic 5597815084 Receives reassigned benefits from 1 practitioner
Practice locations: Norwalk, CT

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
New York Chiropractic College, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

83 E Ave
Suite 313
Norwalk, CT 06851-4919
Phone (203) 838-9795

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326240000000",
    "number": "1265442834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "83 EAST AVE STE 313",
            "city": "NORWALK",
            "state": "CT",
            "postal_code": "068514902",
            "telephone_number": "203-838-9795",
            "fax_number": "203-853-2078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "83 EAST AVE STE 313",
            "city": "NORWALK",
            "state": "CT",
            "postal_code": "068514902",
            "telephone_number": "203-838-9795",
            "fax_number": "203-853-2078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OVERLAND",
        "first_name": "KEITH",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-08",
        "last_updated": "2012-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "CT",
            "license": "333",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jan 11, 2012; 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.