Individual provider Active NPI

Richard Steven Wilson, DC

  • Chiropractor
  • Bethel, CT
National Provider Identifier
1316173768
Registry record updated Mar 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1127 Issued in CT
Practice address
2 Stony Hill Rd Ste 207
Bethel, CT 06801-1045
Phone
(203) 794-4685
NPI assigned
May 29, 2009
Last updated
Mar 10, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 10, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1127 CT Primary

Addresses

Primary practice location

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

Mailing address

2 Stony Hill Rd Ste 207
Bethel, CT 06801-1045
Phone (203) 394-2410

Other practice location 1

2333 Black Rock Tpke, Lowr Level, Hall 2
Fairfield, CT 06825
Phone (203) 794-4685

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180330000463 CT Practitioner - Chiropractic 6406118595 Reassigns benefits to 1 organization
Practice locations: Bethel, CT

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
National University of Arts and Sciences, Medical Department, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2 Stony Hill Rd
Suite 207
Bethel, CT 06801-1045
Phone (203) 794-4685

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
001127CTMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Modern Spine Health and Injury Care LLC Chiropractor CurrentSince Mar 10, 2023 Accepting new patients
Carpenos Chiropractic Center Past Accepting new patients

Locations

2 Stony Hill Rd
Ste 207
Bethel, CT 06801
Phone (203) 794-4685

2333 Black Rock Tpke
Lowr
Fairfield, CT 06825
Phone (203) 794-4685

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1243555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678406400000",
    "number": "1316173768",
    "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"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2333 Black Rock Tpke, Lowr Level, Hall 2",
            "address_purpose": "LOCATION",
            "city": "Fairfield",
            "state": "CT",
            "postal_code": "06825",
            "country_code": "US",
            "telephone_number": "203-794-4685",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "RICHARD",
        "middle_name": "STEVEN",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-05-29",
        "last_updated": "2023-03-10",
        "certification_date": "2023-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CT",
            "license": "1127",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethel, CT

Sources for this page

  • 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.
  • 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.