Individual provider Active NPI

David S Schiller, D.C.

  • Chiropractor
  • Avon, CT
National Provider Identifier
1386773380
Registry record updated Nov 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
000939 Issued in CT
Practice address
25 Bailey Rd
Avon, CT 06001-3671
Phone
(860) 676-9660
Fax
(860) 676-9159
NPI assigned
Mar 5, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 000939 CT Primary
Sports Physician Chiropractor 111NS0005X 000939 CT

Addresses

Primary practice location

25 Bailey Rd
Avon, CT 06001-3671

Mailing address

25 Bailey Rd
Avon, CT 06001-3671
Phone (860) 676-9660

Other identifiers 1

IdentifierTypeStateIssuer
050000939CT02OtherCTANTHEM BC BS OF CT

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120208000117 CT Practitioner - Chiropractic 1052578713 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
New York Chiropractic College, 1990
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

25 Bailey Rd
Avon, CT 06001-3671
Phone (860) 676-9660

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
000939CTMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Schiller Family Organization, LLC Chiropractor CurrentSince Mar 6, 2017 Accepting new patients

Locations

25 Bailey Rd
Avon, CT 06001
Phone (860) 676-9660

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321920000000",
    "number": "1386773380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 BAILEY RD",
            "city": "AVON",
            "state": "CT",
            "postal_code": "060013671",
            "telephone_number": "860-676-9660",
            "fax_number": "860-676-9159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 BAILEY RD",
            "city": "AVON",
            "state": "CT",
            "postal_code": "060013671",
            "telephone_number": "860-676-9660",
            "fax_number": "860-676-9159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHILLER",
        "first_name": "DAVID",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-05",
        "last_updated": "2011-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CT",
            "license": "000939",
            "primary": true
        },
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "CT",
            "license": "000939",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BC BS OF CT",
            "identifier": "050000939CT02",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Avon, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2011; 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.