Individual provider Active NPI

Jennifer Worsman, DC

  • Chiropractor
  • Plainfield, CT
National Provider Identifier
1366593295
Registry record updated Aug 21, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CT001267 Issued in CT
Practice address
36 Railroad Ave
Plainfield, CT 06374-1217
Phone
(860) 317-1212
Fax
(860) 317-1379
NPI assigned
Jan 16, 2007
Last updated
Aug 21, 2013By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 21, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CT001267 CT Primary

Addresses

Primary practice location

36 Railroad Ave
Plainfield, CT 06374-1217

Mailing address

36 Railroad Ave
Plainfield, CT 06374-1217
Phone (860) 317-1212

Other identifiers 2

IdentifierTypeStateIssuer
004223880MedicaidCT
050001267CT02OtherCTANTHEM BC AND BS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080514000559 CT Practitioner - Chiropractic 8123197365 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
New York Chiropractic College, 1996
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

36 Railroad Ave
Plainfield, CT 06374-1217
Phone (860) 317-1212

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CT001267CTMDChiropractor
001267CTMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Plainfield Family Chiropractic, LLC Chiropractor CurrentSince Mar 3, 2014 Accepting new patients
Frederick a Barks, Jr Past Accepting new patients
Lynn Carnaroli Chiropractic Center of Norwich Chiropractor Past Accepting new patients

Locations

36 Railroad Ave
Plainfield, CT 06374
Phone (860) 317-1212

Organizations & group practices 3

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": "1168905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377043200000",
    "number": "1366593295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36 RAILROAD AVE",
            "city": "PLAINFIELD",
            "state": "CT",
            "postal_code": "063741217",
            "telephone_number": "860-317-1212",
            "fax_number": "860-317-1379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36 RAILROAD AVE",
            "city": "PLAINFIELD",
            "state": "CT",
            "postal_code": "063741217",
            "telephone_number": "860-317-1212",
            "fax_number": "860-317-1379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WORSMAN",
        "first_name": "JENNIFER",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-16",
        "last_updated": "2013-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CT",
            "license": "CT001267",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004223880",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BC AND BS",
            "identifier": "050001267CT02",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Plainfield, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2013; 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.