NPIMap

Organization Active NPI

Jmsejb1 LLC

  • Chiropractor
  • Stamford, CT
National Provider Identifier
1467860635
Registry record updated Jul 31, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
001313 Issued in CT
Legal business name
JMSEJB1 LLC
Practice address
3034 Summer St
Stamford, CT 06905-4311
Phone
(860) 278-9141
Fax
(860) 525-4013
NPI assigned
Jul 31, 2014
Last updated
Jul 31, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2014

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

Authorized official

Name
Dr. Karlos Boghosian, D.C.NPI 1104999291
Title
Memeber
Phone
(860) 278-9141

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 001584 CT
Chiropractor 111N00000X 001313 CT Primary

Addresses

Primary practice location

3034 Summer St
Stamford, CT 06905-4311

Mailing address

24 Lewis St
Hartford, CT 06103-2501
Phone (860) 278-9141

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150120001971 CT Part B Supplier - Clinic/Group Practice 1658695747 Receives reassigned benefits from 1 practitioner
Practice locations: Stamford, CT

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1406764800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1406764800000",
    "number": "1467860635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 LEWIS ST",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061032501",
            "telephone_number": "860-278-9141",
            "fax_number": "860-525-4013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3034 SUMMER ST",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069054311",
            "telephone_number": "860-278-9141",
            "fax_number": "860-525-4013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JMSEJB1 LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-31",
        "last_updated": "2014-07-31",
        "status": "A",
        "authorized_official_last_name": "BOGHOSIAN",
        "authorized_official_first_name": "KARLOS",
        "authorized_official_title_or_position": "MEMEBER",
        "authorized_official_telephone_number": "860-278-9141",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CT",
            "license": "001584",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CT",
            "license": "001313",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stamford, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2014; 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.