Henderson Family Chiropractic LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

001443 Issued in CT

Legal business name

HENDERSON FAMILY CHIROPRACTIC LLC

Practice address

1097 Farmington Ave
Berlin, CT 06037-2241

Phone

(860) 828-8220

Fax

(860) 828-8220

NPI assigned

May 16, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Walter Henderson Jr., D.C.NPI 1801945548

Title

Doctor/Owner

Phone

(860) 828-8220

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

Enrollment records 1

Practitioners 2

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

• Walter E. Henderson Jr., D.C.

  • Chiropractor
  • Berlin, CT
  • NPI 1801945548
  Medicare reassignment NPD Authorized official
• Kimberly Henderson-Kjellen, PSYD

  • Clinical Psychologist
  • Berlin, CT
  • NPI 1417044165
  NPD (past)

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

{
    "created_epoch": "1305504000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1307577600000",
    "number": "1265725899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1097 FARMINGTON AVE",
            "city": "BERLIN",
            "state": "CT",
            "postal_code": "060372241",
            "telephone_number": "860-828-8220",
            "fax_number": "860-828-8220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1097 FARMINGTON AVE",
            "city": "BERLIN",
            "state": "CT",
            "postal_code": "060372241",
            "telephone_number": "860-828-8220",
            "fax_number": "860-828-8220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HENDERSON FAMILY CHIROPRACTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-16",
        "last_updated": "2011-06-09",
        "status": "A",
        "authorized_official_last_name": "HENDERSON",
        "authorized_official_first_name": "WALTER",
        "authorized_official_title_or_position": "DOCTOR/OWNER",
        "authorized_official_telephone_number": "860-828-8220",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "CT",
            "license": "001443",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Green Lotus Creative Healing Center LLC
• Kelsey Hale, PSYD
• Carrie M Hartney, DC
• Haven Help Inc
• Healing Connections Wellness LLC
• Kimberly Henderson-Kjellen, PSYD
• Walter E. Henderson Jr., D.C.
• Courtney Higgins, LMSW
• Leah Hinchliffe
• Holistic Healing Therapy & Coaching LLC

• All providers in Berlin, CT
• Chiropractor in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2011; 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.