Organization Active NPI

Keystone Chiropractic LLC

  • Chiropractor
  • Hamden, CT
National Provider Identifier
1457548018
Registry record updated Dec 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
001570 Issued in CT
Legal business name
KEYSTONE CHIROPRACTIC LLC
Practice address
2660 State St
Hamden, CT 06517-2226
Phone
(203) 675-1644
Fax
(203) 281-4466
NPI assigned
Sep 27, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2024

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

Authorized official

Name
Dr. Jason B Richards, D.C.
Title
Owner
Phone
(203) 675-1644

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 001570 CT Primary

Addresses

Primary practice location

2660 State St
Hamden, CT 06517-2226

Mailing address

2660 State St
Hamden, CT 06517-2226
Phone (203) 675-1644

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040827000593 CT Part B Supplier - Clinic/Group Practice 8729053335 Receives reassigned benefits from 1 practitioner
Practice locations: North Haven, CT

National Provider Directory

National Provider Directory

Locations

2660 State St
Hamden, CT 06517
Phone (203) 675-1644

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1190851200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733788800000",
    "number": "1457548018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2660 STATE ST",
            "city": "HAMDEN",
            "state": "CT",
            "postal_code": "065172226",
            "telephone_number": "203-675-1644",
            "fax_number": "203-281-4466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2660 STATE ST",
            "city": "HAMDEN",
            "state": "CT",
            "postal_code": "065172226",
            "telephone_number": "203-675-1644",
            "fax_number": "203-281-4466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEYSTONE CHIROPRACTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-27",
        "last_updated": "2024-12-10",
        "certification_date": "2024-12-10",
        "status": "A",
        "authorized_official_last_name": "RICHARDS",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "203-675-1644",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "CT",
            "license": "001570",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hamden, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2024; 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.

Verify at the official NPI Registry.