Active NPI
Alyssa Beth Greene, D.C.
- Chiropractor
- Hartford, CT
National Provider Identifier
1366526055
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- CT1389
- Practice address
- 576 Farmington Ave
Hartford, CT 06105-3015 - Phone
- (860) 233-1212
- Fax
- (860) 233-6565
- NPI assigned
- Oct 25, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | CT1389 | CT | Primary |
Addresses
Primary practice location
576 Farmington Ave
Hartford, CT 06105-3015
Mailing address
576 Farmington Ave
Hartford, CT 06105-3015
Phone (860) 233-1212
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 004215895-01 | Medicaid | CT |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CT
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20101118000959 | CT | Practitioner - Chiropractic | 5092901884 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1389 | CT | MD | Psychologist |
| CT1389 | CT | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Connecticut Diagnostics LLC | Chiropractor | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161734400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1366526055",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "576 FARMINGTON AVE",
"city": "HARTFORD",
"state": "CT",
"postal_code": "061053015",
"telephone_number": "860-233-1212",
"fax_number": "860-233-6565"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "576 FARMINGTON AVE",
"city": "HARTFORD",
"state": "CT",
"postal_code": "061053015",
"telephone_number": "860-233-1212",
"fax_number": "860-233-6565"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREENE",
"first_name": "ALYSSA",
"middle_name": "BETH",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-25",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "CT",
"license": "CT1389",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "004215895-01",
"state": "CT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Hartford, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.