Prohealth Chiropractic Center, LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

001726 Issued in CT

Legal business name

PROHEALTH CHIROPRACTIC CENTER, LLC

Practice address

1127 Tolland Turnpike
Suite 102
Manchester, CT 06042

Phone

(860) 432-7432

Fax

(860) 432-7432

NPI assigned

Jan 18, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Jason Allen Sousa, D.C.NPI 1558439398

Title

Owner Chiropractor

Phone

(860) 432-7432

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in CT

Enrollment records 1

Locations

Practitioners 2

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

• Jason Allen Sousa, DC

  • Chiropractor
  • Manchester, CO
  • NPI 1558439398

  CT

  Medicare reassignment Authorized official
• Kiara Tiedt, DC

  • Chiropractor
  • South Windsor, CT
  • NPI 1851148472
  NPD

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

{
    "created_epoch": "1200614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216166400000",
    "number": "1306022496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1127 TOLLAND TURNPIKE",
            "address_2": "SUITE 102",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "06042",
            "telephone_number": "860-432-7432",
            "fax_number": "860-432-9049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1127 TOLLAND TURNPIKE",
            "address_2": "SUITE 102",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "06042",
            "telephone_number": "860-432-7432",
            "fax_number": "860-432-7432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROHEALTH CHIROPRACTIC CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-18",
        "last_updated": "2008-07-16",
        "status": "A",
        "authorized_official_last_name": "SOUSA",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "ALLEN",
        "authorized_official_title_or_position": "OWNER CHIROPRACTOR",
        "authorized_official_telephone_number": "860-432-7432",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "CT",
            "license": "001726",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "CT",
            "license": "001722",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP MEDICARE",
            "identifier": "C03898",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "432191999",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PROVIDER NUMBER",
            "identifier": "ME1910",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Susan N. Price, LCSW
• Pristine Smile Dental PLLC
• Stephanie Gabrielle Proano, APRN
• Professional Family Therapy-LLC
• Professional Pathology Services LLC
• Prospect CT Medical Foundation, Inc.
• Prospect Manchester Hospital, Inc.
• Prospect Manchester Hospital, Inc.
• Heather A Prouty
• Jaclyn D Provencher

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2008; 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.