Individual provider Active NPI

John Louis Mormile, DC

  • Chiropractor
  • Portland, CT
National Provider Identifier
1467444562
Registry record updated Mar 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
540 Issued in CT
Practice address
234 Main St
Portland, CT 06480-1861
Phone
(860) 342-7277
Fax
(860) 342-7281
NPI assigned
Aug 16, 2005
Last updated
Mar 24, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 540 CT Primary
Chiropractor 111N00000X CH0004991 FL

Addresses

Primary practice location

234 Main St
Portland, CT 06480-1861

Mailing address

234 Main St
Portland, CT 06480-1861
Phone (860) 342-7277

Other identifiers 6

IdentifierTypeStateIssuer
NHS338OtherCTOXFORD
050000540CT03OtherCTANTHEM
061632199-01OtherCTPRISM
2V0679OtherCTHEALTHNET
CT00540OtherLANDMARK
4212157OtherCTAETNA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
540CTMDChiropractor
CH0004991FLMDChiropractor
000540CTMDAthletic Trainer

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, 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": "1124150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1206316800000",
    "number": "1467444562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "234 MAIN ST",
            "city": "PORTLAND",
            "state": "CT",
            "postal_code": "064801861",
            "telephone_number": "860-342-7277",
            "fax_number": "860-342-7281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "234 MAIN ST",
            "city": "PORTLAND",
            "state": "CT",
            "postal_code": "064801861",
            "telephone_number": "860-342-7277",
            "fax_number": "860-342-7281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORMILE",
        "first_name": "JOHN",
        "middle_name": "LOUIS",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-16",
        "last_updated": "2008-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CT",
            "license": "540",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH0004991",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "NHS338",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "050000540CT03",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRISM",
            "identifier": "061632199-01",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "2V0679",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LANDMARK",
            "identifier": "CT00540",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4212157",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.