Active NPI
John Louis Mormile, DC
- Chiropractor
- Portland, CT
National Provider Identifier
1467444562
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 540
- 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, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| NHS338 | Other | CT | OXFORD |
| 050000540CT03 | Other | CT | ANTHEM |
| 061632199-01 | Other | CT | PRISM |
| 2V0679 | Other | CT | HEALTHNET |
| CT00540 | Other | LANDMARK | |
| 4212157 | Other | CT | AETNA |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 540 | CT | MD | Chiropractor |
| CH0004991 | FL | MD | Chiropractor |
| 000540 | CT | MD | Athletic 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.
-
- Chiropractor
- Portland, CT
- NPI 1477735454
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.