Individual provider Active NPI

Andrew W Fitzsimons, DC

  • Chiropractor
  • Glastonbury, CT
National Provider Identifier
1366528937
Registry record updated May 27, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1050 Issued in CT
Practice address
131 New London Tpke
Suite 103
Glastonbury, CT 06033-2246
Phone
(860) 633-7890
Fax
(860) 633-5721
NPI assigned
Oct 27, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 27, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1050 CT Primary

Addresses

Primary practice location

131 New London Tpke
Suite 103
Glastonbury, CT 06033-2246

Mailing address

131 New London Tpke
Suite 103
Glastonbury, CT 06033-2246
Phone (860) 633-7890

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091005000745 CT Practitioner - Chiropractic 2668518663 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
National College of Chiropractic, 1992
Medicare assignment
May accept Medicare assignment
Group practices
Connecticut Chiropractic LLCGroup PAC ID 6204972292, 2 clinicians

Practice addresses (Care Compare)

78 Eastern Blvd
Suite 9
Glastonbury, CT 06033-4327
Phone (860) 659-9969

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

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": "1161907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211846400000",
    "number": "1366528937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "131 NEW LONDON TPKE",
            "address_2": "SUITE 103",
            "city": "GLASTONBURY",
            "state": "CT",
            "postal_code": "060332246",
            "telephone_number": "860-633-7890",
            "fax_number": "860-633-5721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "131 NEW LONDON TPKE",
            "address_2": "SUITE 103",
            "city": "GLASTONBURY",
            "state": "CT",
            "postal_code": "060332246",
            "telephone_number": "860-633-7890",
            "fax_number": "860-633-5721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FITZSIMONS",
        "first_name": "ANDREW",
        "middle_name": "W",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-27",
        "last_updated": "2008-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CT",
            "license": "1050",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glastonbury, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2008; 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.